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Maricopa Integrated Health System Reports 90 Percent Reduction in Pressure Ulcers

Using a Protocol of Care that Included Solutions(R) Algorithms from ConvaTec(1)

SKILLMAN, N.J., June 12 /PRNewswire/ -- A retrospective analysis conducted by clinicians at Maricopa Integrated Health System (MIHS) found that a protocol of care using a standardized algorithm with advanced products reduced the prevalence of pressure ulcers by 90 percent, according to data presented this week at the 41st Annual Conference of the Wound, Ostomy and Continence Nurses (WOCN) Society.(1)

Under the recently established MIHS Center for Clinical Excellence, nursing officers selected Solutions(R) Algorithms, an evidence-based wound assessment, treatment and prevention guideline from ConvaTec, a world-leading provider of medical technologies for community and hospital care, as the foundation for increasing competency in skin and wound care.

Targeting pressure ulcer prevention has been a key goal across the system, especially following the inclusion of Stage 3 and 4 pressure ulcers acquired after admission to a healthcare facility on the list of "never events" by the Centers for Medicare and Medicaid Services (CMS).

More than 1,100 MIHS nurses were trained on the use of the algorithms. MIHS also utilized the advanced products specified in the evidence-based protocol for pressure ulcer prevention: the Aloe Vesta(R) skin care system, DuoDERM(R) dressings and the Flexi-Seal(R) Fecal Management System (FMS). After the first year, a prevalence audit showed more than a 50 percent reduction in hospital-acquired pressure ulcers. By December 2008, following the full roll-out of the interactive algorithms, a second audit reported a 90 percent reduction.(1)

"With Solutions(R) Algorithms and the right products, we achieved our goal of significantly reducing the prevalence of pressure ulcers across our entire system, and improving patient care in line with quality of care standards," said Joann Bowser, RN, BSN, and clinical practice educator with MIHS in Phoenix, AZ. "In addition, the easy-to-use interactive algorithms have helped all of our nurses 'work smarter, not harder,' applying validated best practices in skin and wound care with even more consistent results."

First launched by ConvaTec ten years ago, the Solutions(R) Algorithms printed manuals have been content validated by multiple groups of wound care professionals and global opinion leaders. In 2007, Solutions(R) Algorithms was accepted by the National Guideline Clearinghouse as the only comprehensive set of content-validated wound care algorithms.(6) According to a recent publication from the Agency for Healthcare Research and Quality (AHRQ), the Solutions(R) Algorithm for Pressure Ulcer Prevention was described as a proven technique that can be used to enhance patient outcomes.(7)

Numerous clinical studies utilizing the algorithms with proven, advanced skin and wound care products have produced positive outcomes in multiple care settings.(2-4) The latest review, presented in April 2008, found that using specified products within standardized protocols was associated with better, more economical wound outcomes than using certain off-protocol products within the same protocol of care.(5)

The products specified in the Solutions(R) Algorithms for pressure ulcer prevention:

  • Aloe Vesta(R) skin care products provide patients with a comprehensive portfolio of cleansing, bathing, moisturizing, and protection products that can help maintain skin integrity and prevent pressure ulcers, when utilized as part of a protocol of care.
  • DuoDERM(R) dressings were the first dressings to incorporate hydrocolloid technology. Their effectiveness in wound care is now well established and supported by a comprehensive evidence base.(8)
  • Flexi-Seal(R) FMS, also supported by clinical evidence,(9) is a temporary containment device for patients with acute fecal incontinence designed to safely and effectively divert fecal matter, protect patients' wounds from fecal contamination, and reduce the risk of both skin breakdown and spread of infection, such as Clostridium difficile (C. difficile).

The Solutions(R) Algorithms Interactive Resource is available on CD-ROM by calling 1-800-422-8811.

About ConvaTec

ConvaTec is a leading developer and marketer of innovative medical technologies that have helped improve the lives of millions of people worldwide. With four key business divisions - Ostomy Care, Wound Therapeutics, Continence and Critical Care and Infusion Devices - ConvaTec products support health care professionals from the hospital to the community health setting. From its headquarters in Skillman, New Jersey, the company oversees more than 8,000 employees in over 90 countries serving consumers and their health care professionals on six continents. For more information, please visit

About MIHS

Maricopa is an Integrated Health System with historic roots back to 1871. It was established as a "special purpose unit of government" with taxing authority and a publicly selected board of directors. Maricopa is a JCAHO accredited health care system which includes a 460 bed acute care facility, including the second largest Burn Center in the United States. Maricopa also includes 10 community health clinics located through Maricopa County, the fourth largest in the United States. The Maricopa Center for Clinical Excellence was launched in the Fall of 2007, with the goal to promote enhanced wound competencies to better service MIHS clients and a commitment to provide comprehensive safe patient care to all those who live in Maricopa County, including the underserved and medically needy. In December 2008, MIHS was awarded JCAHO's "Gold Seal Award" demonstrating adherence to quality health care standards.

Solutions, Aloe Vesta, DuoDERM and Flexi-Seal are registered trademarks of ConvaTec Inc.

Our world is what we make of it is a trademark of ConvaTec Inc.

(1) Bowser J. How Solutions(R) Algorithms are making a difference at Maricopa Integrated Health System (MIHS). Presentation at: The 41st Annual Conference of the Wound, Ostomy and Continence Nurses (WOCN) Society; June 6-10, 2009; St. Louis, MO.

(2) Beitz J, van Rijswijk L. Using wound care algorithms: A content validation study. J WOCN. 1999;26:238-249.

(3) Lyder C, Shannon R, Empleo-Frazier O, McGehee D, White, C. A comprehensive program to prevent pressure ulcers in long-term care: Exploring costs and outcomes. Ostomy Wound Manage. 2002;48(4): 52-62.

(4) Bolton L, McNees P, van Rijswijk L, et al. Wound healing outcomes using standardized care in clinical practice. J WOCN 2004;31(3):65-71.

(5) Bolton, Laura. Do products affect wound outcomes when using standardized algorithms? Presented at: The 21st Annual Symposium on Advanced Wound Care and Wound Healing Society Meeting; April 24-27, 2008; San Diego.

(6) National Guideline Clearinghouse. U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality. (search: wound care algorithm). Accessed June 8, 2009.

(7) Lyder, C. Chapter 12, Pressure Ulcers: A Patient Safety Issue. In: Patient Safety and Quality. An Evidence-Based Handbook for Nurses. Agency for Healthcare Research and Quality. (AHRQ). Accessed: June 10, 2009.

(8) Thomas S. Hydrocolloid dressings in the management of acute wounds: a review of the literature. Int Wound J. 2008;5:602-613.

(9) Padmanabhan A, Stern M, Wishin J, Mangino M, Richey K, DeSane M. Clinical evaluation of a flexible fecal incontinence management system. Am J Crit Care. 2007;16(4):384-393.


    Punnie Donohue

    Courtney Judd
    Weber Shandwick

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