Pressure Ulcers to Zero

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Pressure Ulcers to Zero, a large scale improvement healthcare collaborative began in February 2014. This collaborative was the first large scale improvement collaborative to take place in Ireland and was supported by the Quality Improvement Division, Health Service Executive (HSE) and the Royal College of Physicians Ireland (RCPI), through the National Quality Improvement Programme. The primary aim of this collaborative was to reduce the incidence of avoidable pressure ulcers within the former Dublin North East (DNE) region and to increase the capacity and capability of frontline clinical teams to improve the care they deliver. 

Twenty one teams from across a range of settings within DNE including hospitals, primary care centre’s, nursing homes and other community and private residential centre’s partnered up with staff, patients and carer’s to achieve this aim.

Why Pressure Ulcers?

The collaborative placed an intentional focus on pressure ulcer prevention as pressure ulcers are:

·        an increasing problem that affect thousands of people unnecessarily every year

·        painful, debilitating and can be life threatening

The cost of treating a pressure ulcer can vary but it has been estimated that it costs €119,000 to successfully treat one patient with a grade 4 pressure ulcer. Based on this figure, it is estimated that it could cost €250 million per annum to manage pressure ulcers across all care settings in Ireland (Gethin et al.2005)


Healthcare collaboratives involve teams and individuals from various health disciplines and from different settings, such as hospitals, residential settings and primary care teams, working together in partnership to achieve improvements and to reach an agreed goal of high quality, safe, standardised care to patients in an efficient and effective manner. The teams that participated in the Pressure Ulcers to Zero collaborative are part of an active learning community, learning from each other and from recognised experts.


A goal was set to reduce the incidence of avoidable pressure ulcers in the participating settings by 50% over six months with an ultimate goal of reaching of 0%. Results from this Collaborative showed a 73% reduction in pressure ulcers overall in the Dublin North East Region. This reduction in pressure ulcers over the course of this collaborative is clearly outlined in the run chart below.


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