Becker’s Healthcare Podcast: Using Prophylactic Dressing To Reduce Pressure Injuries

Release Date: August 5, 2025

Introduction

In this insightful episode of Becker’s Healthcare Podcast, host Dr. Lee Ruzzi engages with Sue Crehan, a seasoned wound care nurse consultant, to delve into the effective use of prophylactic dressings in reducing pressure injuries. The conversation navigates through best practices, the intricacies of different multilayer foam dressings, and emerging research in the field.

The Ongoing Challenge of Pressure Injuries

Dr. Ruzzi opens the discussion by highlighting the rising incidence of pressure injuries in healthcare settings, emphasizing both the quality of life impact on patients and the significant financial burdens on institutions.

“Pressure injuries is one of the hospital acquired conditions that has been very difficult for clinicians to wrap their arms around in order to reduce the incidence...”
— Sue Crehan [01:46]

Sue Crehan elaborates on the complexity of preventing pressure injuries, noting the myriad of patient-specific factors such as comorbidities, medications, and individual health statuses. She underscores that unlike other hospital-acquired conditions that may be mitigated through straightforward checklists, pressure injury prevention requires nuanced, evidence-based bedside practices tailored to each patient.

“It's not only a matter of just one size fits all... you have to be able to give and take. You have to be able to constantly being, assessing and reassessing the patient...”
— Sue Crehan [03:00]

Organizational Best Practices for Pressure Injury Prevention

Transitioning from bedside practices, Dr. Ruzzi prompts Sue to discuss organizational-level strategies to combat pressure injuries. Sue passionately advocates for a multifaceted approach that involves all levels of the healthcare organization.

“Pressure injuries are not just a nursing issue for many, historically speaking... it is a hospital concern. It needs to be dealt with on an organizational level...”
— Sue Crehan [05:14]

Key organizational strategies include:

• Senior Leadership Engagement: Leaders must understand pressure injury data and the underlying causes, ensuring they are actively involved in prevention initiatives.

• Resource Allocation: Adequate staffing and the removal of systemic barriers are crucial for effective pressure injury prevention.

• Comprehensive Programs: Implementing programs that span all inpatient units and involve diverse staff roles ensures widespread adherence to prevention protocols.

The Role of Prophylactic Dressings in Prevention

A significant portion of the discussion focuses on the innovative use of prophylactic multilayer foam dressings. Sue shares her experience at Virginia Commonwealth University (VCU), where she led a proactive pressure injury prevention program that successfully integrated prophylactic dressings into standard care protocols.

“After, I think it was 120 plus patients that we did this quality improvement project on, found that the pressure injuries in the control group... we found a significant difference...”
— Sue Crehan [14:25]

This initiative demonstrated a marked reduction in pressure injuries, illustrating that prevention is not only clinically effective but also financially beneficial by mitigating the high costs associated with treating such injuries.

Differences Among Multilayer Foam Dressings

Dr. Ruzzi inquires about the efficacy of different multilayer foam dressings. Sue provides a nuanced perspective, cautioning that not all multilayer foam dressings are created equal.

“No, not all multilayer foam dressings are equal. It is actually apples and oranges and watermelons.”
— Sue Crehan [23:24]

She emphasizes the importance of selecting dressings with robust research backing their effectiveness. Specifically, she highlights Smith and Nephew's "A Leave in Life" dressing, which has been scientifically proven to absorb a significant portion of frictional forces, thereby reducing shear—a critical factor in pressure injury development.

“When the dressing is in place, the dressing itself is able to absorb 30 to 45% of the frictional force...”
— Sue Crehan [28:50]

Sue warns against assuming a class effect among various brands, advocating for evidence-based selection to ensure clinical efficacy.

Future Directions and the Prophylactic Dressing Standards Initiative

Looking ahead, Sue discusses the NPIAP's Prophylactic Dressing Standard Initiative, an ongoing effort to establish clear criteria for labeling dressings as prophylactic. This initiative aims to differentiate clinically effective products from those marketed without substantial evidence.

“They’re compiling information... these are the types of testing that industry should do... to identify whether or not that dressing truly is prophylactic.”
— Sue Crehan [31:01]

This standardization will empower clinicians to make informed decisions, ensuring optimal patient outcomes and safeguarding against ineffective or harmful products.

Conclusion

The episode concludes with a reaffirmation of the collective responsibility in pressure injury prevention. Sue underscores the paramount importance of keeping the patient at the center of all clinical decisions and leveraging the right tools to prevent these potentially life-threatening injuries.

“We have to make sure you're choosing a company... it's proven to be effective, and it tells you in the research project or the research study why it's effective.”
— Sue Crehan [23:24]

Dr. Ruzzi and Sue both express gratitude for the collaborative efforts in advancing pressure injury prevention, highlighting the ongoing commitment required from all healthcare stakeholders.

Key Takeaways:

1. Pressure Injuries Are Complex: Multiple patient-specific factors make prevention challenging, necessitating individualized, evidence-based approaches.

2. Organizational Commitment is Crucial: Effective prevention requires engagement from all levels of the healthcare organization, particularly senior leadership.

3. Prophylactic Dressings Are Effective When Evidence-Based: Not all multilayer foam dressings are equal; selecting products with solid research backing ensures efficacy.

4. Standardization Efforts are underway: Initiatives like the NPIAP's Prophylactic Dressing Standard will help clinicians make informed decisions.

5. Patient-Centered Care Remains Paramount: Ensuring the patient remains at the core of prevention strategies is essential for optimal outcomes.

This episode serves as a comprehensive guide for healthcare professionals seeking to enhance their pressure injury prevention strategies through evidence-based practices and organizational support.