Endocrine Abstracts

Objective: To assess the impact of launching SKIN (Surface, Keep moving, Incontinence, Nutrition) bundle on development of pressure foot ulcers among in-patients with diabetes.

Methods: SKIN Bundle was launched at Dudley Group of Hospitals Foundation Trust in mid- February 2011. Data on pressure foot ulcers were collected among patients with and without diabetes admitted during February 2010– February 2011 and then from February 2011–March 2012, from pressure ulcer database.

Results: Between 14/02/2010 and 13/02/2011, number of admissions to adults’ wards was 64,000. Of these, 5,452 had diabetes. Out of the latter, 72 patients were identified to have foot ulcers, of them 23 patients developed the foot ulcers during their hospital stay, giving rise a 0.42% rate of development of hospital acquired foot ulcers among in-patients with diabetes. During the thirteen and a half month period following SKIN bundle launch (14/02/2011 – 31/03/2012), there were 13 patients who developed hospital acquired foot ulcers out of 6,232 in-patients with diabetes admitted during the same period, giving rise to a lower rate (0.21%) of development of foot ulcers in the hospital among patients with diabetes. The development of hospital acquired foot ulcers among patients with diabetes, therefore, dropped significantly by 51% P value of 0.04 (P<0.05) after the launching SKIN bundle. The average length of hospital stay (LOS) among patients with diabetes who had foot ulcers was significantly shorter by an average of 3.55 days, P value of 0.044 (P<0.05), after this SKIN bundle implementation.

Conclusion: SKIN bundle resulted in more than 50% reduction in pressure foot ulcers, with significant decrease in LOS among those who developed ulcers. SKIN Bundle can therefore be considered as a tool to reduce inpatient pressure Ulcers.