You are aware of the many benefits of repositioning your patients. Effective patient positioning has been a focal point throughout the history of nursing. Among the many benefits of proper positioning, preservation of skin integrity is an important factor as the costs of treating a pressure ulcer are estimated to range from $4,000 to $40,000 for newly developed ulcers.(1) The Agency for Healthcare Research and Quality (AHRQ) defines a pressure ulcer as a lesion caused by unrelieved pressure resulting in damage to underlying tissue.(2)
Pressure ulcers are not unique to modern times, as they have been discovered
on the remains of Egyptian mummies.(3)

Abundant literature spanning various practice settings and specialties reveals it is much more cost-effective to focus on prevention rather than treatment of pressure ulcers.

Studies demonstrate that 3% to 10% of the population in both hospital and community health care settings acquire some degree of pressure damage.(4)

The resulting cost, patient discomfort, and increased hospital length of stay (LOS) are significant.
The cost of pressure ulcer treatment exceeds more than $1 billion annually in the United States.

This is estimated to be two and one-half times the cost of prevention.(5)

Most of the previous research concentrates on long-term care settings, intensive care units (ICU), and rehabilitation units; with little attention given to the acute care setting. These studies led to the development of protocols, policies, procedures, and educational programs aimed at decreasing nosocomial pressure ulcers. Improvements have been made in the identification and production of effective pressure-reducing surfaces; however, the prevalence and incidence of pressure ulcers are not diminishing.

Researchers have found that pressure ulcers are a significant, independent predictor of both hospital costs and LOS.(6)
Each year, approximately 1.6 billion patients develop hospital-acquired pressure ulcers at a cost of $2.2 to $3.6 billion. Of these ulcers, 23% occur on surgical patients undergoing procedures lasting more than three hours and represent an annual direct cost of $750 million to $1.5 billion.(7)

Another study found that patients who develop iatrogenic pressure ulcers have a mean hospital cost $1,877 greater and a LOS four days longer than patients who do not develop pressure ulcers. For patients who develop a stage II or greater pressure ulcer, costs are $15,229 greater and LOS is extended eight days longer than patients without pressure ulcers.

Another group of researchers found that patients who develop pressure ulcers have an average LOS seven days longer than patients who do not develop ulcers.(8)

In addition to increased dollars, other costs are associated with pressure ulcer development. Increased pain, infectious complications, additional use of hospital resources, failure to heal, and increased mortality may occur in patients with pressure ulcers.

One study found that death is more likely to occur in these patients.(9)
Findings show that 67% of pressure ulcer patients die during hospitalization compared to 15% of pressure ulcer negative patients and that increased mortality extends through the first year postdischarge.(10)
In fact, 59.5% of patients who develop pressure ulcers die within one year of discharge compared to 38.2% of patients without pressure ulcers.

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