Preventing pressure injuries in New Zealand

21 Jan 2016 | Other Topics

The Health Quality & Safety Commission, ACC and the Ministry of Health have released a report that looks at the economic and social harm caused by pressure injuries. The report, The case for investment in: A quality improvement programme to reduce pressure injuries in New Zealand can be downloaded at the bottom of this page.

Pressure injuries, also known as pressure ulcers or bed sores, are a major cause of harm for patients using health care services. With the right knowledge and care, most pressure injuries can be prevented.

Commission Medical Advisor Dr Iwona Stolarek says that there are local and regional prevention initiatives, but New Zealand does not currently have a national programme to prevent pressure injuries. The KPMG report advises on the likely benefits of such a programme.

"The report recommends a multi-agency, long-term commitment to preventing pressure injuries in New Zealand. The report is a step towards fully understanding the size of the problem, so we can build on the good work already undertaken and increase the focus on preventing pressure injuries."

She says the Commission, ACC and the Ministry of Health will work together with health sector stakeholders, in phases over three to four years to prevent pressure injuries. Progress will be evaluated at four years.

The report made 20 recommendations. These recommendations have informed and underpin the phased work these three agencies are planning.

Ministry of Health Chief Nurse Dr Jane O’Malley says pressure injuries are an important concern for the people who suffer from them and for the people who provide care.

"The Ministry supports making prevention of pressure injuries a national priority across sectors including home and community, residential aged care and hospitals.

"Parts of the health sector already have a significant focus on preventing pressure injuries and some good progress has been made. However, pressure injuries remain a major cause of preventable harm for people using health care services."

Dr O’Malley says the Ministry of Health is committed to working with the Commission, ACC and other health sector partners on national and local quality improvement initiatives to prevent pressure injuries.

Dr Peter Robinson, Chief Medical Advisor at ACC, says the report puts a spotlight on pressure injuries in New Zealand, and the need to improve patient safety in this area.

"A number of government agencies are working collaboratively to create a national prevention programme with an initial focus on preventing grade III and IV pressure injuries.

"ACC looks forward to working with the Ministry and Commission to further enhance our coordinated response to pressure injuries."

Report findings
  • An estimated 55,000 people receive a pressure injury every year in New Zealand with a prevalence estimated at 4–8 percent.
  • Pressure injuries can occur quickly (between 1–4 hours of admission to a health service).
  • Pressure injuries are more commonly associated with age, immobility, incontinence and malnutrition.
  • Most pressure injuries can be prevented through improved care practices, consistent measurement and implementing clinical guidelines.
  • Reducing pressure injuries will reduce direct health service costs and improve quality of life for people at risk of pressure injuries.
  • Every grade III pressure injury (estimate of 2500 cases per year) costs around $123,000.
  • The annual direct cost of pressure injuries is estimated at around $68 million.
  • It is difficult to put a cost on quality of life and suffering from pressure injuries but the report estimates total annual cost of pressure injuries to society is $694 million (including quality adjusted life years [QALY] calculation).
About pressure injuries
  • Pressure injuries usually develop over ‘bony’ parts of the body due to sustained pressure, or pressure combined with shear and/or friction.
  • They cause physical symptoms, feelings of anger and blame, and reduce quality of life through pain, infection, delayed healing, altered body image and depression, and increased mortality and morbidity.
  • Pressure injuries impact the New Zealand health system by increasing patients’ length of stay, ACC treatment injury claims and care costs.
  • With the right knowledge and care, most pressure injuries can be avoided. All health professionals, family/whānau members and patients have important roles to play in prevention.

There is a belief by some health care providers that pressure injuries cannot be avoided in the more frail and palliative patients. For others they may also carry a connotation of neglect and mismanagement of care. But evidence tells us that pressure injuries are in fact preventable.

Collaborating across central agencies, and the broader health sector, presents us with a great opportunity to improve clinical leadership, organisational culture and promote more transparent reporting of pressure injuries.

This will build a culture of learning from pressure injury incidents to improve the quality of care we deliver, with prevention of pressure injuries at the fore.

More information about pressure injuries is available on the Commission website.

Last updated 21/01/2016