According to international studies 5 – 25 % of all patients with limited mobility (slow-goes and no-goes) are affected by bedsore (lat. decubitus). For prophylaxis and treatment of decubitus, a system will be developed, capable on the one hand to actively involve people with high decubitus risk in decubitus prophylaxis, and which on the other hand eases the encouragement of high risk patients by professional caregivers.
Bedsore (lat. decubitus) is an impairment of the skin and of underlying tissue which is caused by continuous pressure. It is a common problem of people with limited mobility (slow-goes and no-goes). In Germany 12.5 % of all patients in clinics and 6.6 % of all persons in nursing homes were affected in 2005. In the Netherlands statistics report even higher numbers, indicating that 16.9 % of all patients in clinics, 25.5 % of all patients in nursing homes and 12.6 % of the people in home care are affected. Decubitus is associated with pain, reduced autonomy, social isolation and reduced quality of life, and it involved high costs for the health care system.
In order to minimize the risk for decubitus several tools for pressure reduction are commonly used (e.g. pillows, decubitus mattresses, etc.). Additionally, the kind of bedding, regular changes in body position, preservation and advancement of tissue tolerance in combination with the state of nutrition, continence-management and hygiene are critical factors. The first step in decubitus therapy is always to capture and classify the wound status, including the ultimate cause of the wound, the influence factors (pressure, temperature, humidity) and their documentation.
Since the persons concerned and their family members are usually responsible for the treatment of decubitus ulcera (sometimes in cooperation with caregivers), special attention needs to be turned on their support. Due to the high number of possible reasons for development of decubitus and due to the complexity of influence factors on the decubitus risk, a system will be developed, which employs two major concepts:
- Involvement of affected persons (slow-goes and no-goes empowerment) and their relatives in decubitas prophylaxes
- Facilitation of encouragement of high risk patients by professional caregivers
The system will force risk reducing behavior of affected persons themselves and their relatives (e.g. by forcing them to change their body position). The efficiency of interventions made will be visualized. This way, the risk for development of decubitus can be minimized, detection of decubitus can be accelerated and finally therapy of decubitus can traceably be documented. The critical point is to incorporate affected persons and their family members in risk assessment, decubitus prophylaxis and treatment by end user empowerment. In the course of the project, existing sensors will be identifies, validated and (if necessary) modified, which can be used for minimizing the risk for decubitus or optimizing its therapy. Possible sensors include pressure sensor mats, position transducers, perfusion sensors, oxidation sensors, sensors describing the wound milieu, etc. Finally, feedback should be provided to the affected persons via familiar technology, e.g. via television (“You should sit up again”). Recording and transmission of photos should easily be possible as well.
Besides continuous feedback to the affected persons – in case the affected person agrees – the recorded data are provided to family members, caregivers, physicians etc. Therefore, the developed system will be integrated into existing software solutions for electronic nursing and care documentation. If necessary, it should be possible to give the attending physician access to the (selected) data.
A prototypical system will be validated in the course of a study.