Author: Evan Call, MS, CSM
Previously, clinicians attempting to reduce heel pressure ulcer prevalence considered only three factors: pressure, shear and friction. However, an
additional factor receiving attention in recent years is microclimate.
An RCT to Determine the Effect of a Heel Elevation Device in Pressure Ulcer Prevention Post-hip Fracture
J. Donnelly, PhD., BSc (Hons) Health Studies, MCGI, RGN, ONC
A study (J. Donnelly, PhD., BSc (Hons) Health Studies, MCGI, RGN, ONC) published in the Journal of Wound Care (Vol 20, NO 7, July 2011) sets out to compare the differences between complete offloading and “standard care” in the prevention of heel pressure ulcers in post-hip fracture patients. The randomized control trial (RCT) was conducted in the fracture trauma unit of a major tertiary referral center in Belfast, Ireland.
Isabel Bales, RN/BSN/CWOCN
This experimental study compared the effectiveness of an intravenous bag with the Heelift Suspension Boot in preventing heel pressure ulcers. The study is the first to examine the effectiveness of intravenous bags in the prevention of heel ulcers.
By Theda Bordner, MSN, RN
Hip fracture patients are particularly vulnerable to sacral and heel pressure ulcers because of a lack of mobility. In this study, hip fracture patients who were given Heelift Suspension Boot to offload the heel did not develop any heel pressure ulcers.
Joan A. McInerney, MSN, RN, BC, CWOCN and Sandra K. Wheeler, BSN, RN, CWOCN | NCH Healthcare System, Naples, FL
This post illustrates the reduction of heel pressure ulcer prevalence at the NCH Healthcare System in Naples, Florida. The two-hospital system created a multi-disciplinary team that focused on assessment, consultation, and heel pressure ulcer prevention. Use of Heelift Suspension Boot was a key part of the new pressure ulcer protocol.
Nicole L. Sender RN, DNS, University Place Care Center, Tacoma, WA and Linda Manning PT, CWS, Physiotherapy Associates, Lakewood, WA
The purpose of this study was to see if amputation could be prevented by using more conservative treatment methods. A multi-disciplinary team used several tools, including Heelift® Suspension Boot, to help prevent amputation of limbs injured by pressure ulcers.
Barbara Delmore, Sarah Lebovits, Philip Baldock, Barbara Suggs, and Elizabeth Ayello describe their efforts to reduce heel pressure ulcers in their facility, which resulted in a decrease in heel pressure ulcer prevalence from 7.3% to 1.3% in 3 years.
A presentation by Dr. Diane Langemo, in association with Position Health, called Heel Pressure Ulcers: A to Z. This presentation includes important information about how heel pressure ulcers form, how they can be prevented, and why Heelift® boots effectively help prevent heel pressure ulcers.
Serves as the authoritative voice for improved patient outcomes in pressure injury prevention and treatment through public policy, education and research. As longtime NPUAP Corporate Board Members, Position Health also recommends these webinars.
Denis B. Drennan, MD
In this article, Dr. Denis B. Drennan, DM Systems founder, establishes a formula for figuring a facility’s heel pressure ulcer costs. Dr. Drennan also makes the case that investing in heel pressure ulcer prevention is more economical than treating heel pressure ulcers.
Institute for Clinical Systems Improvement (ICSI). Pressure ulcer treatment. Health care protocol. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2008 Jan. 28 p. [36 references]
Heel Pressure Ulcer Guidelines for treatment from the National Guideline Clearinghouse, the US Department of Health & Human Services, and the Agency for Healthcare Research and Quality (AHRQ). The emphasis in these guidelines is on education for patients, caregivers, and family members because education is a key component of prevention. Significantly, the guidelines also focus on the importance of pressure ulcer prevention plans and protocols.
Position Health surveyed wound care professionals at several different trade shows and conferences. Most notably, the respondents preferred heel offloading devices 6-1 over pillows.
Evonne Fowler, RN,CNS, CWOCN; Suzy Scott-Williams, MSN, RN, CWOCN; and James B. McGuire, DPM, PT, CPed, CWS, FAPWC
This detailed article by Evonne Fowler, et. al., details why pressure relief or offloading is the most significant key to preventing heel pressure ulcers, including the difference between heel protectors versus heel offloading devices. The article also analyzes the “total patient” approach to preventing heel ulcers.
Desmond Bell, DPM | Podiatry Today
Diabetic heel ulcers pose particular challenges in the way of treatment because so many factors can impact the patient and the patient’s healing process. With those challenges in mind, this article details wound bed preparation, key considerations like offloading, and how peripheral arterial disease may affect a patient’s ability to heal.
Microclimate is becoming an increasingly important consideration in the prevention and treatment of heel pressure ulcers. This white paper begins with a clear definition of micrclimate and then goes on to explain why heat and moisture can contribute to skin breakdown in patients at risk for heel pressure ulcers. The ramifications of incorporating microclimate factors into a heel pressure ulcer prevention regiment are discussed last, including a summary of recent test results proving that heel offloading devices like Heelift Glide, with an open cell foam design, are better at releasing heat and moisture than other types of professional offloading devices.
In a recent study by the North Carolina State University College of Textiles, heel offloading boots made of different kinds of materials were tested for microclimate performance. In the study, open cell foam like that used in Heelift Brand Boots performed the best.
The National Quality Forum, together with the Center for Medicare and Medicaid Services, categorized Heel Pressure Ulcers (HPUs) as “never events” in 2008. Five years later, a “perfect storm” of obstacles has evolved that makes preventing hospital-acquired pressure ulcers more difficult. These obstacles include documented nurse shortages, newly discovered complexities about why patients develop pressure ulcers, and a rising number of elderly patients who are at risk for developing heel pressure ulcers.
In the face of these challenges, how can heel pressure ulcer prevalence decrease?
This white paper summarizes the challenges that facilities are facing in regards to lowering heel pressure ulcer prevalence. It also details how a multidisciplinary approach (together with an effective heel offloading device) can come together to beat the “perfect storm” of obstacles that currently hinder efforts to prevent heel pressure ulcers.