For patients and their families, the emergence of a decubitus ulcer is painful and stressful. Thankfully, most decubitus ulcers are often noticeable in the earliest stages and are easily treated, with very few passing beyond Stage 2. In fact, many hospitals have special monitoring programs in place to prevent the development of pressure ulcers all together.

However, Kennedy Terminal Ulcers are not so easily prevented or treated. Named after the nurse practitioner who discovered them, Kennedy Terminal Ulcers typically occur in geriatric patients and often transforms from an initial blister directly to a Stage 4 pressure ulcer with just a few hours. Treatment for these ulcers usually focuses on pain relief because, as the name suggests, patients typically do not recover from them. In fact, most patients who develop Kennedy Terminal Ulcers die within 24 hours.

Proper treatment involves stringent turning regimens and wound treatment. Depending on the amount of drainage, caregivers will typically use a hydrocolloid, foam, gel, or calcium alginate if there are high amounts of drainage. Typically, however, these ulcers do not have much drainage. If there is slough (yellow tissue) or necrotic tissue (black tissue) caregivers will move to a debridement method such as an enzymatic debriding agent, autolytic debridement method (thin film, hydrocolloid) or mechanical debridement method (wet to dry).

Although it is unlikely for patients to recover from Kennedy Terminal Ulcers, recovery is sometimes possible if the treatment methods are ideal. Turning patients is the simplest and most effective method for preventing and treating pressure ulcers, yet ensuring that patients are turned in a timely fashion can be difficult in the busy hospital environment.  Today, technology such as Dalcon Alert exists that automatically notifies clinicians when it is time  to turn patients.

2011 looks to be an exciting year for healthcare reform. Some of the new healthcare bill’s changes are already being implemented.

Hospital-Acquired Infection Reporting

Starting this month, hospitals are now required to report hospital-acquired infection rates to Medicare. Hospitals that fail to do so will lose 2% of their Medicare reimbursement money in 2012. Reducing hospital-acquired infection rates has the potential to save $45 billion per year. The data collected will be readily available on hospital compare.

Physician Compare

A “Physician Compare” website is also in the works. This site is wrapped in controversy as it will publish physician-specific data on efficiency, outcomes of diagnoses/treatment, care coordination, and more. It will also contain data on specific non-physician caregivers, such as nurses and nurse practitioners. While the rules for the website will certainly undergo a thorough revision process, individual specific healthcare data will become easily accessible to the American public.

However, this year may also see the death of the reform bill. The new House Committee Chair of healthcare policy, Rep. Fred Upton (R-Mich.), has vowed that if the House cannot repeal the bill in its totality, representatives will “go after the bill piece by piece. We will look at these individual pieces to see if we can’t have the thing crumble.”

Democrats in the Senate have sworn to defend the reform bill should a repeal vote come up through the House. Democrats argue that consumers already are benefitting from the changes being made. They claim that undoing the law would increase the number of uninsured Americans, place control of health insurance back into the hands of insurers, and increase the federal budget deficit.
FILED UNDER BLOG · TAGGED WITH HEALTHCARE REFORM, HOSPITAL ACQUIRED INFECTIONS, PHYSICIAN COMPARE