When discussing pressure injuries, the topic of cost saving often centers around methods of prevention. After all, preventing even one injury saves on staff time and resources, and improves the quality of life for the patient.
But not all pressure injuries are going to be prevented. In fact, pressure injuries remain one of the most common health issues in the US. That doesn't mean that prevention is failing. It means the problem is enormous and must be addressed at all levels. The cost of treatment must be taken into account.
But it's a mistake to believe that there are only two options - in-house treatment and prevention. In fact, a third option may be emerging that may be even better. It won't replace efforts toward prevention that are helping transform the clinical setting, but it may knock down some of the costs of treatment until the affliction can be largely eradicated.
The third option is self-care: empowering the patient to apply his or her own treatment. The more treatments created to allow patients to care for their own wounds, the less of a strain pressure injuries take on the staff of a medical facility and its resources.
Self-care also has the merit of bringing all of the elements in treatment together. The patient is fully informed and in control of how the treatment is administered. Family members can be brought deeper into the process to serve as front line caregivers. And nurses and medics can play a supervisory role, leaving them more time to manage other issues, improving overall care at their facility.
Treatment of Venous Injuries Shows the Value of Self-Care
When it comes to pressure injuries in the legs, there is good news and bad news.
The Good News
The medical establishment has found an effective treatment for sores in the legs.
According to Leanne Atkin, Vascular Nurse Specialist, University of Huddersfield, compressions have proven effective at treating pressure injuries on the legs. They reduce healing time and have a lower rate of recurrence.
Ms. Atkin also noted that the compressions have evolved dramatically since the method was introduced in the 1970s, moving from crepe bandages to two layer kits, then four layer kits, to leg wraps, and finally to the compression hosiery kits used today.
"The more advanced we’ve gotten in compression therapy, the better results we’ve seen. Compression therapy is THE treatment for venous leg ulcers, producing results in 12 weeks," she said.
The Bad News
Not enough people are getting the best treatment.
Ms. Atkin noted that as little as 20% of the patients who would benefit from compression treatment actually receive it. Some of the biggest factors reducing the number include:
Lack of continuity of care - as clinicians change in the course of long-term care, so do essential elements such as dressing choice and bandages. All treatment choices go according to the clinician responsible at the time.
Shortage of nursing resources - Not all personnel have training in the latest techniques in compression, making it harder to expect that the treatment will be applied consistently over the course of months.
At the same time, Ms. Atkin points out that the path of optimal treatment costs 10 times less than any of the sub-optimal paths.
"To ensure patients receive timely, effective care, we need to move toward self-care – leg ulcer hosiery kits - so they can handle a compression layer independent of available nurses’ skill or consistency," she concluded.
Self-Care Products Will be the Wave of the Future
The leg hosiery kit Ms. Atkin describes is a simple design made to be administered by the patient. It consists of three layers:
- After the dressing is applied, there is a silky liner that’s easy to put on
- The liner holds dressings in place and helps the second layer slide on easily
- A second compression layer is added over the liner to achieve consistent therapeutic pressure
The kit was designed with the patient in mind, including comfort and ease of application. As more facilities look for ways to increase self-care, designers will take the appropriate feedback from patients and continue to improve the design.
The kit can also serve as a model for products that improve treatment while lowering costs. By making it easy enough for patients to handle on their own, they are empowering patients while improving the quality of their care.
The Benefits of Self-Care
Not all patients will be able to administer their own care for pressure injuries. Many may lack the dexterity needed to use the compression kit or other form of self-care. Some who can use it may find it uncomfortable or ill-fitting and seek a different option. Some skin may be too sensitive for the kit.
But regardless of the specific applications of various products, the more people who are able to help themselves, the more involvement and control they have over their own health situation.
The cost benefits of self-care are obvious. Nurses only have to watch and see that the healing is on track. The kits themselves cost less than the four layer option that involve a great deal of bandages.
It proves that there are more options when it comes to cost reduction. Moving toward self-care may save money and provide patients with the best overall care, all at once.