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Economic Evaluations of Strategies to Prevent Hospital-Acquired Pressure Injuries. 2017

Wrechelle Ocampo, and Amanda Cheung, and Barry Baylis, and Nancy Clayden, and John M Conly, and William A Ghali, and Chester H Ho, and Jaime Kaufman, and Henry T Stelfox, and David B Hogan
Wrechelle Ocampo, MBT • Research Associate • W21C Research and Innovation Centre, Cumming School of Medicine • University of Calgary • Calgary, Alberta • Canada Amanda Cheung, MBT, BS • Research Assistant • W21C Research and Innovation Centre, Cumming School of Medicine • University of Calgary • Calgary, Alberta • Canada Barry Baylis, MD • Executive Codirector • W21C Research and Innovation Centre, Cumming School of Medicine • University of Calgary • Calgary, Alberta • Canada • Clinical Associate Professor • Department of Medicine • University of Calgary Nancy Clayden, EMT-P • Research Associate • W21C Research and Innovation Centre, Cumming School of Medicine • University of Calgary • Calgary, Alberta • Canada John M. Conly, MD • Medical Director • W21C Research and Innovation Centre, Cumming School of Medicine • University of Calgary • Calgary, Alberta • Canada • Professor • Departments of Medicine, Pathology and Laboratory Medicine, and Microbiology, Immunology and Infectious Diseases • University of Calgary William A. Ghali, MD • Scientific Director • O'Brien Institute for Public Health • University of Calgary • Calgary, Alberta • Canada • Professor • Division of General Internal Medicine, Departments of Medicine and Community Health Sciences • Cumming School of Medicine • University of Calgary Chester H. Ho, MD • Associate Professor and Head • Department of Clinical Neurosciences • University of Calgary • Calgary, Alberta • Canada Jaime Kaufman, PhD • Manager • W21C Strategic Programs • W21C Research and Innovation Centre • Cumming School of Medicine • University of Calgary • Calgary, Alberta • Canada Henry T. Stelfox, MD, PhD • Associate Professor • Departments of Community Health Sciences, Medicine, and Critical Care Medicine • University of Calgary • Calgary, Alberta • Canada David B. Hogan, MD • Brenda Stafford Foundation Chair • Geriatric Medicine • Calgary, Alberta • Canada • Professor • Departments of Medicine, Clinical Neurosciences, and Community Health Sciences • Cumming School of Medicine • University of Calgary • Calgary, Alberta • Canada.

OBJECTIVE To provide information from a review of literature about economic evaluations of preventive strategies for pressure injuries (PIs). BACKGROUND This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. OBJECTIVE After participating in this educational activity, the participant should be better able to:1. Identify the purpose and methods used for this study.2. Compare costs and effectiveness related to preventative strategies for PIs. BACKGROUND: Pressure injuries (PIs) are a common and resource-intensive challenge for acute care hospitals worldwide. While a number of preventive strategies have the potential to reduce the cost of hospital-acquired PIs, it is unclear what approach is the most effective. OBJECTIVE The authors performed a narrative review of the literature on economic evaluations of preventive strategies to survey current findings and identify important factors in economic assessments. METHODS Ovid, MEDLINE, NHS Economic Evaluation Databases, and the Cochrane Database of Systematic ReviewsSELECTION CRITERIA: Potentially relevant original research articles and systematic reviews were considered. METHODS Selection criteria included articles that were written in English, provided data on cost or economic evaluations of preventive strategies of PIs in acute care, and published between January 2004 and September 2015. Data were abstracted from the articles using a standardized approach to evaluate how the items on the Consolidated Health Economic Evaluation Reporting Standards checklist were addressed. RESULTS The searches identified 192 references. Thirty-three original articles were chosen for full-text reviews. Nineteen of these articles provided clear descriptions of interventions, study methods, and outcomes considered. CONCLUSIONS Limitations in the available literature prevent firm conclusions from being reached about the relative economic merits of the various approaches to the prevention of PIs. The authors' review revealed a need for additional high-quality studies that adhere to commonly used standards of both currently utilized and emerging ways to prevent hospital-acquired PIs.

UI MeSH Term Description Entries
D007049 Iatrogenic Disease Any adverse condition in a patient occurring as the result of treatment by a physician, surgeon, or other health professional, especially infections acquired by a patient during the course of treatment. Hospital-Acquired Condition,Condition, Hospital-Acquired,Conditions, Hospital-Acquired,Disease, Iatrogenic,Diseases, Iatrogenic,Hospital Acquired Condition,Hospital-Acquired Conditions,Iatrogenic Diseases
D003668 Pressure Ulcer An ulceration caused by prolonged pressure on the SKIN and TISSUES when one stays in one position for a long period of time, such as lying in bed. The bony areas of the body are the most frequently affected sites which become ischemic (ISCHEMIA) under sustained and constant pressure. Bedsore,Decubitus Sore,Decubitus Ulcer,Pressure Injury,Pressure Sore,Bed Sores,Bed Sore,Bedsores,Decubitus Sores,Decubitus Ulcers,Injury, Pressure,Pressure Injuries,Pressure Sores,Pressure Ulcers,Sore, Bed,Sore, Decubitus,Sore, Pressure,Ulcer, Decubitus,Ulcer, Pressure
D005102 Health Expenditures The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (HEALTH CARE COSTS) and may or may not be shared among the patient, insurers, and/or employers. Expenditure,Expenditures, Health,Health Expenditure,Out Of Pocket Expenditure,Out-of-Pocket Cost,Out-of-Pocket Expense,Out-of-Pocket Payment,Expenditures,Expenditures, Direct,Expenditures, Indirect,Expenditures, Out-of-Pocket,Out-of Pocket Expenditures,Out-of-Pocket Costs,Out-of-Pocket Expenses,Out-of-Pocket Payments,Out-of-Pocket Spending,Cost, Out-of-Pocket,Costs, Out-of-Pocket,Direct Expenditure,Direct Expenditures,Expenditure, Direct,Expenditure, Health,Expenditure, Indirect,Expenditure, Out-of Pocket,Expenditure, Out-of-Pocket,Expenditures, Out of Pocket,Expenditures, Out-of Pocket,Expense, Out-of-Pocket,Expenses, Out-of-Pocket,Indirect Expenditure,Indirect Expenditures,Out of Pocket Cost,Out of Pocket Costs,Out of Pocket Expenditures,Out of Pocket Expense,Out of Pocket Expenses,Out of Pocket Payment,Out of Pocket Payments,Out of Pocket Spending,Out-of Pocket Expenditure,Out-of-Pocket Expenditure,Out-of-Pocket Expenditures,Payment, Out-of-Pocket,Payments, Out-of-Pocket,Spending, Out-of-Pocket
D006760 Hospitalization The confinement of a patient in a hospital. Hospitalizations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D017046 Cost Savings Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer. Cost Saving,Saving, Cost,Savings, Cost
D058996 Quality Improvement The attainment or process of attaining a new level of performance or quality. Improvement, Quality,Improvements, Quality,Quality Improvements

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