The Problem

People get pressure ulcers (bed sores) when they sit or lie in one position for too long.  This reduces blood flow to the skin under pressure and the skin starts to break down.  Other factors like nutrition and diabetes can contribute to the problem.  Pressure ulcers are a large problem for people who have limited mobility such as in hospitals and nursing homes.  PU take a long time to heal and can cause complications such as infection which spreads.  This is an expensive problem for the health system.

The best way to approach this problem is to assess all patients for their risk of pressure ulcer and to design a care plan which minimizes the chance of skin breakdown.  Prevention includes proper nutrition, treatment of existing conditions and local skin care.  One of the most effective methods of preventing pressure ulcer is to ensure that patients do not spend a prolonged time in one position.  Patients may need to be turned every two hours to prevent pressure ulcers.

We have designed a set of tools:

–Assessment of patient's risk for pressure ulcer

–Treatment plan for existing pressure ulcer

–Preventive care plan for pressure ulcer

–Patient position monitoring tool with reminders to nursing staff

Assessment of Patient

This is the first step.  All patients should have an assessment.  I am developing a tool which will go through a standard assessment (Braden or Norton Scales) of patient:

–Sensory perception

–Moisture

–Activity

–Mobility

–Nutrition

–Friction and shear

The initial assessment also examines for existing pressure ulcers and other medical conditions.

This assessment tool currently runs on Android smart phones and tablets and sends data using standard protocols to electronic medical records.

Care Plan

Based on the assessment a care plan is developed to address deficiencies and treat existing conditions and prevent further problems.  The care plan is an automatic outcome of the assessment and is presented on the portable device or a health facility web site for local access.

Patient Monitoring

This is the most innovative part of this submission.  I have designed a simple device which can be attached to the patient (abdomen) which measures their position and activity (temperature also) and continuously transmits this information to the nurses using Bluetooth or WiFi.  This information can be used to alert nurses to patient inactivity and can be used to measure the quality of the patient activity and trigger intervention (turning the patient).

Software

All of the data is processed to use health information standards, namely HL7, LOINC, and IHTSDO (Snomed) as well as specific nursing protocols from the National Pressure Ulcer Advisory Panel.