New advances in pressure ulcer prevention and management: an Australian perspective
09/02/10 | Pressure ulcers, Service development and delivery, Skin integrity | Keryln Carville
This short report describes how innovative research helped to standardise data collection for pressure ulcer prevalence in Australia. Adoption of this approach and the implementation of national guidelines in 2001 led to reduced pressure ulcer rates and to several state-wide prevalence surveys. New data collection tools, including the use of mobile phone technology for immediate centralised analysis, and the implementation of new interactive initiatives such as the WoundsWest Education Program will be discussed.
Key innovations in Australia
- Standardising a methodological approach to benchmarking
- Using mobile phone technology to collect pressure ulcer data
- Introducing an online wound management education programme.
"There is an immense amount of zinc rubbing but I have not met with a single observation as to whether there was a danger of bed sores"
(Florence Nightingale, 1881) 
Miss Nightingale's observation on reading the nurse probationers' diaries was indeed prudent and ahead of contemporary thinking. It was not until 80 years later that health professionals, and nurses in particular, were using risk assessment tools for predicting pressure ulcers . It proved to be as equally long before a scientific approach was adopted to ascertain the physiology of pressure ulcer formation and determine the best evidence for their prevention and management.
This report focuses on the developments in Australia that have contributed to implementation of national guidelines, an interactive online educational programme and the use of mobile phone technology to facilitate accurate data collection and immediate remote analysis of data.
HISTORY OF PREVALENCE STUDIES IN AUSTRALIA
The first published study on pressure ulcer prevalence in Australia appeared in 1983, when the comparative prevalence rates of two hospitals were reported . An increasing number of surveys were conducted during the 1990s, but there were discrepancies in the methods employed to collect data . These discrepancies were mainly found in the testing methods, including the tools used, the pressure ulcer education provided, the inter-rater reliability testing, the populations surveyed, skin inspections versus documentation audits, the staging systems employed, and the endpoints .
International benchmarking data on pressure ulcer prevalence and incidence has the potential to contribute to positive outcomes in the prevention of these debilitating wounds. However, while an increasing number of international health services are gathering such data, the opportunity for effective benchmarking is being lost because of a lack of consensus around the methodology employed.
- International benchmarking data on pressure ulcer prevalence and incidence can help to raise awareness and reduce PU occurrence
- Although an increasing number of international health services are gathering data, there is a lack of consensus around the methodology employed leading to benchmarking difficulties