PRODUCT INFORMATION Oral Hygiene p. 1 Antiseptic Body

®
PRODUCT INFORMATION
Oral Hygiene
p. 1
Antiseptic Body Cleanser
p. 13
Prepackaged Bathing
p. 16
Incontinence Care
p. 21
Heel Protection
p. 27
THE ORAL CAVITY
Proven source of
Ventilator-Associated
Pneumonia (VAP)
The oral cavity is a proven source of ventilatorassociated pneumonia (VAP).1,2 Bacteria that
cause nosocomial respiratory disease colonize
the oropharyngeal area, including dental
plaque.3-5 These pathogens
can be aspirated into the
lungs and cause infection.5
Meanwhile, comprehensive
“One of the most critical risk
factors for ventilator-associated
pneumonia is microbial
colonization of the oropharynx.”6
oral hygiene addresses three
VAP risk factors—bacterial colonization of the
oropharyngeal area, aspiration of subglottic
secretions, and colonization of dental plaque
with respiratory pathogens.1
THE COST OF VAP
VAP is the most common infectious
complication among ICU patients,
accounting for up to 47% of
all infections.7
Mortality rates as high as 70%.8
A 9,080-patient U.S. study found, the
average VAP patient spends 9.6
additional days on mechanical ventilation,
6.1 extra days in the ICU, and 11.5 more
days in the hospital.9
Mean total hospital charges of
US$150,841!10
VAP patients incurred an average of
US$48,948 in additional hospital costs
compared to uninfected patients.10
REFERENCES
1. Schleder B, et al., J Advocate Health Care. 2002 Spr/Sum;4(1):27-30. 2. Tablan OC, et al., Guidelines for preventing health-care--associated pneumonia,
2003, Recommendations of CDC and Healthcare Infection Control Practices Advisory Committee (HICPAC), 2003. 3. Scannapieco FA, J Periodontology.
1999 Jul;70(7):793-802. 4. Scannapieco FA, et al., Crit Care Med. 1992 Jun ;20(6):740-5. 5. Fourrier F, et al., Crit Care Med. 1998;26:301-8. 6.
Munro CL, Grap MJ, Am J Crit Care. 2004 Jan;13(1):25-33. 7. Cason CL, et al., Am J Crit Care. 2007 Jan;16(1):28-38. 8. Sole ML, et al., Am J Crit Care.
2002 Mar;11(2):141-9. 9. Rello J, et al., Chest. 2002 Dec;122(6):2115-21. 10. Kollef MH, et al., Chest. 2005;128(6):3854-62. 11. Mori H, et al.,
Intensive Care Med. 2006 Feb;32(2):230-6. Epub 2006 Jan 25. 12. Nursing management of oral hygiene. Clinical practice guidelines, Singapore Ministry
of Health. 2004 Dec (accessed 07-06-07 at http://www.hpp.moh.gov.sg/HPP/1136783794707.html).
1
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GLOBAL SUPPORT FOR
CLINICAL ORAL CARE
FRANCE
DENTAL PLAQUE STUDY5
“…Specific dental hygienic measures must be
considered with the primary goal of preventing
plaque colonization.”
“…Dental plaque must be considered a specific
reservoir of colonization and subsequent
nosocomial infection in ICU patients.”
JAPAN
IMPORTANCE OF BRUSHING STUDY11
BRUSHING ESSENTIAL IN REDUCING VAP
BY 62.5% IN THE ICU
“Dental plaque, which is the major cause of
oral contamination, is the thickest biofilm in the
living body and cannot be eliminated by gargling
or wiping. Therefore, cleanliness of the oral cavity
cannot be obtained by means other than
mechanical cleaning including tooth brushing and
washing….This study found that oral care consisting
of tooth brushing and washing reduced the
incidence and risk of VAP in ICU patients, and that it
delayed the onset of VAP.”
U.S.
CENTERS FOR DISEASE CONTROL AND
PREVENTION (CDC) GUIDELINES2,*
FOR PREVENTING HEALTHCARE-ASSOCIATED
PNEUMONIA
THREE OF THE RISK
FACTORS FOR VAP1:
1. Colonization of dental plaque with
respiratory pathogens
“…Develop and implement a comprehensive
oral-hygiene program (that might include use of an
antiseptic agent) for patients in acute-care settings
or residents in long-term--care facilities who are at
risk for health-care--associated pneumonia (II).”
* In addition to other interventions.
2. Bacterial colonization of the
oropharyngeal area
SINGAPORE
3. Aspiration of subglottic secretions*
NURSING MANAGEMENT OF ORAL HYGIENE
CLINICAL PRACTICE GUIDELINES 2004
* Routine suctioning minimizes oral secretions
which can migrate to the subglottic area.
MINISTRY OF HEALTH12
Oral hygiene “should be performed at least
twice a day.”
“Toothbrushes should be the first line of oral
cleansing method unless the patient is prone to
bleeding, pain or aspiration. Brush teeth at least
twice a day, preferably soon after waking in the
morning and before going to bed. Use soft-bristled,
small-ended toothbrush.”
+1 815-455-4700
2
COMFORT BATH® |
Cleansing Washcloths with Skin Check™ Guide
TOOTHETTE® ORAL CARE
Targets VAP Risk Factors
Reducing bacterial colonization in the mouth
and on the surface of the teeth of ICU patients
decreases the frequency of VAP.1,2 While oral
care is now a high priority, only one brand is
REDUCING VAP
delivering the
outcomes that
prove it.
Toothette® Oral
“…The mere reduction of risk
through better oral hygiene
can lead to fewer VAPs.”3
Care addresses risk factors with a
comprehensive approach based on cleaning,
debriding, suctioning and moisturizing the
entire oral cavity. All tools and interventions are
designed to make it easier to maintain a
A U.S. hospital implemented
comprehensive oral care and reduced
VAP by over 60%. Their protocol featured
Toothette brand products and called for
oral care every 2 to 4 hours.3,*
In a 4-year, 1,614-patient study in AACN
News, Toothette Oral Care helped achieve
a statistically significant, 42.1% VAP
reduction—preventing 21 cases in the
MICU and avoiding US$722,975 in costs.1
healthy oral cavity.
REDUCING HAP
In a 2-year, Japanese study at 11 nursing
homes, pneumonia risk was significantly
reduced in patients receiving oral care. In
fact, mortality due to pneumonia was
about half that of patients not receiving
oral care.4
COST AVOIDANCE
In 17 months, one 350-bed U.S.
hospital reduced VAP over 75%, avoiding
US$1.6 million in costs. Along with a
ventilator bundle and head-of-bed
elevation, they upgraded from swabs only
to Q•Care® cleansing and suctioning every
2 to 4 hours.5
* Other contributing risk factors exist, but were not addressed in this study.
REFERENCES
1. Vollman K, Garcia R, Miller L, AACN News. 2005 Aug;22(8):12-6. 2. Mori H, et al., Intensive Care Med. 2006 Feb;32(2):230-6. Epub 2006 Jan 25.
3. Schleder B, et al., J Advocate Health Care. 2002 Spr/Sum;4(1):27-30. 4. Yoneyama T, et al., J Am Geriatrics Soc. 2002;50(3):434-8. 5. Sherman Hospital
saves $1.6 million on VAP-related costs. Case study, 2005 (available at http://www.sageproducts.com/company/media2.asp?ArticleID=51). 6. DeWalt EM, Nurs
Res. 1975 Mar-Apr;24(2):104-8. 7. Pearson LS, Hutton JL, J Adv Nurs. 2002 Sep;39(5):480-9. 8. Scannapieco FA, J Periodontology. 1999 Jul;70(7):793-802.
9. Scannapieco FA, et al., Crit Care Med. 1992 Jun ;20(6):740-5. 10. Fourrier F, et al., Crit Care Med. 1998;26:301-8. 11. Sole ML, et al., Am J Crit Care. 2002
Mar;11(2):141-9. 12. Schleder BJ, Nursing Mgmt. 2003 Aug;34(8):27-33. 13. Oral Health Care Drug Products for Over-the-Counter Human Use;Tentative
Final Monograph; Federal Register, 53(17): 2436-61 (available at www.fda.gov/cder/otcmonographs/Oral_Health_Care/oral_health_care_TF_PR_19880127.pdf).
14. Oral Health Care Drug Products for Over-the-Counter Human Use;Establishment of a Monograph;Federal Register,47(101):22760-930 (available at
www.fda.gov/cder/otcmonographs/Oral_Health_Care/oral_health_care_19820525.pdf).
3
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INNOVATIVE TOOLS
SUCTION TOOTHBRUSH
Helps remove dental plaque6,7 debris and oral secretions,
all known to harbor potential respiratory pathogens.8-11
SUCTION SWAB
CLEAN
Helps remove debris and oral secretions—while
stimulating oral tissues3,6,12—between brushings.
Brushing and suctioning mechanically
removes bacterial biofilms (dental plaque)
from teeth and oral tissues.
COVERED YANKAUER
Removes debris and oral secretions. Between uses, its exclusive
sleeve retracts to help contain secretions and protect itself from
environmental debris.
OROPHARYNGEAL SUCTION CATHETER
DEBRIDE
Soft and flexible, it facilitates suctioning of
oropharyngeal secretions above the vocal cords.
Swabbing and suctioning with
Perox-A-Mint® solution helps remove
dead, loosened biofilms.13,14
Y-CONNECTOR
Allows for dedicated oral suctioning.
SUCTION HANDLE
Accommodates your desired suctioning and cleansing tools.
+1 815-455-4700
MOISTURIZE
Water-based formula soothes and
moisturizes oral tissues.
4
Q•CARE SYSTEM SETUP AND USE
1 CONNECTING TO CANISTERS
2 CONNECTING SUCTION HANDLE
OPTION 1:
MULTI-PORT
CANISTER
Attach the Suction
Handle to the tubing.
When possible, attach the
tubing for Q•Care directly to
a suction port on the
canister. Set the YConnector aside for
possible future use.
Suction
OFF
IMPORTANT: When not
in use, make sure the
ON/OFF switch is in the
OFF position to prevent
loss of suction power.
OPTION 2:
SINGLE PORT
CANISTER
3 CLEANSING AND SUCTIONING
If additional suction port
access is needed (i.e., for
closed suction line), attach the
Y-Connector securely to a
suction port on the canister.
Make sure it is completely
seated to prevent loss of
suction power.
Next, attach the tubing for
Q•Care to one Y-Connector
port. Use the remaining
Y-Connector port for an
additional suction connection.
Attach the desired
cleansing and
suctioning tips to the
Suction Handle.
Suction
ON
Suction
OFF
Clean and suction the oral
cavity per hospital protocol.*
Use the ON/OFF switch to
regulate suction power.
*Refer to individual product package for
complete instructions, warnings and
indications.
IMPORTANT: Both ports on
the Y-Connector must be
utilized or a loss of suction
power can occur.
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Suction Handle
to oral
suction
Cleansing and Suctioning Tools
attach to Suction Handle
to wall
suction
to closed
ET suction
MULTI-PORT CANISTER
SINGLE PORT CANISTER
to wall
suction
to oral
suction
Y-Connector
to closed
ET suction
IMPORTANT: Both ports on the
Y-Connector must be utilized or a
loss of suction power can occur.
+1 815-455-4700
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24-HOUR SUCTION SYSTEMS |
Q·Care® Oral Cleansing Suctioning
For Mechanically Ventilated Patients
Q•Care® Systems help remove dental
plaque, debris and oral secretions, all known
to harbor potential respiratory pathogens.
Convenient q8˚ packaging facilitates
compliance with your protocol.
• Maintains closed tracheal system compliance. No need
to “break the system” or add a second canister, Q•Care’s
Y-Connector provides a dedicated line for oral care.
• Suction Handle provides variable suction control and
quick tool changes.
• Suction Toothbrush helps remove dental plaque, debris
and oral secretions. Suction Swab helps remove debris
and secretions between brushings. Both mechanically
clean and refresh with sodium bicarbonate while
stimulating oral tissue.
• Soft-tipped Covered
Yankauer helps
remove debris and
secretions. When
closed, the sleeve
helps contain oral
secretions and
protect the
yankauer from
environmental
debris.
Retractable Sleeve
• Soft, flexible Oropharyngeal Suction Catheter helps
remove secretions from the oropharyngeal area above
the vocal cords.
• No-mix burstable
solution packets
moisten tools with
cleansing solution right
in the package.
• Mouth Moisturizer
soothes and moisturizes
lips and oral tissue with
vitamin E and
coconut oil.
Easy instructions in
multiple languages
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ORDERING INFORMATION
q8° ORAL CLEANSING AND
SUCTIONING SYSTEM
SUCTION HANDLE AND
COVERED YANKAUER
1 Covered Yankauer with Suction
Handle and Y-Connector
2 Packages of 1 Suction Toothbrush
with Sodium Bicarbonate, AlcoholFree Mouthwash, Mouth Moisturizer,
and Applicator Swab
1 Package of 1 Suction Swab with
Sodium Bicarbonate, Alcohol-Free
Mouthwash, Mouth Moisturizer, and
Applicator Swab
1 Package of 1 Oropharyngeal Suction
Catheter
1 Suction Handle and Covered Yankauer
with Y-Connector
60 packages/case
Reorder #6630-X
25 systems/case
Reorder #6808-X
LENGTH OF STAY (LOS)
YANKAUER HOLDER
Bracket with Removable Adhesive Strip
4 bags of 25
100/case
Reorder #6696
Mounts to
IV stands,
walls, etc.
+1 815-455-4700
BEDSIDE BRACKET
With Removable Adhesive Strip
for wall-mounting
for mounting on IV
poles, bedrails, etc.
25 brackets/case
Reorder #6697
25 brackets/case
Reorder #6698
Keeps product
at bedside for
visual reminder
to provide oral
care. Helps
increase
compliance.
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SUCTION SYSTEMS
For non-ventilated patients at risk for aspiration pneumonia
Aspiration pneumonia is a significant risk for
those suffering from dysphagia, stroke, COPD,
malignancy, renal or liver disease, dementia and
more.1,2 Toothette® Oral Care Suction Systems
address risk factors for nosocomial
pneumonias, including aspiration pneumonia.
• Thumb port provides easy suction control. Suction
Toothbrush and Suction Swab connect to standard
suction lines.
• No-mix, burstable
solution packets
moisten tools with
cleansing solution right
in the package.
• Mouth Moisturizer
soothes and moisturizes
lips and oral tissue with
vitamin E and
coconut oil.
1. Marik PE, N Eng J Med. 2001;344(9):665-71. 2. Kozlow JH, et al., Crit Care Med. 2003;31(7):1930-7.
9
1
2
3
Burst solution packet
Open package
Remove swab
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ORDERING INFORMATION
SINGLE USE SUCTION
TOOTHBRUSH SYSTEM
with Alcohol-free mouthwash
SINGLE USE
UNTREATED SUCTION
TOOTHBRUSH SYSTEM
1 Suction Toothbrush with Sodium Bicarbonate
1 Untreated Suction Toothbrush
with Mouth Moisturizer
and Applicator Swab
100 systems/case
Reorder #6573-X
100 systems/case
Reorder #6577-X
SINGLE USE
SUCTION SWAB SYSTEM
UNTREATED SUCTION
TOOTHBRUSH, SUCTION SWAB,
AND APPLICATOR SWAB
with Perox-A-Mint® Solution
2 Suction Swabs with Sodium Bicarbonate
with Mouth Moisturizer
100 systems/case
Reorder #6513-X
Compatible for use with 0.12% Chlorhexidine
Gluconate (CHG) oral rinse.*
1 Suction Toothbrush, Suction
Swab and Applicator Swab
100 systems/case
Reorder #6576-X
* Tested for use up to five minutes. Data available upon request.
+1 815-455-4700
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NON-SUCTION SYSTEMS
For patients who are able to expectorate
The Toothette® Oral Care Single-Use Swab
System is the convenient solution for
cleaning and debriding the oral cavity.
• No-mix, burstable solution packets
moisten tools with cleansing solution right
in the package.
• Mechanically cleans and debrides with 1.5% hydrogen
peroxide, then soothes and moisturizes with Mouth
Moisturizer.
Additional
Components
• Toothette® Plus Oral Swabs
have distinct ridges to help
lift debris and mucus, clean
between teeth and
stimulate oral tissue.
Available with sodium
bicarbonate or untreated.
• Toothette® Oral Swabs are
available with mintflavored dentifrice or
untreated.
LEMON-GLYCERIN SWABS CAN
DRY AND IRRITATE TISSUES AND
DECALCIFY TEETH
“Lemon and Glycerin swabs,
which have been the
mainstay of oral hygiene,
have no mechanical or
cleansing value and
should not be used.”1
• Perox-A-Mint® Solution
mechanically cleans and debrides with 1.5% hydrogen
peroxide.
• Antiseptic Oral Rinse helps reduce the chance of
infection in minor oral irritation with .05%
cetylpyridinium chloride.
• Mouth Moisturizer soothes and moisturizes lips and
oral tissue with vitaminE and coconut oil.
• Ultra-Soft Toothbrush gently removes dental plaque
and debris.
“The lemon juice is a citric
acid that can irritate the oral
mucosa and decalcify the teeth…
Although warnings about potential harmful effects of
lemon and glycerine have been in the literature for
two decades, they are part of a ritual of nursing
practice that has been difficult to change. This
resistance to change is due somewhat to the fact
that, until recently, few alternatives were available.”2
1.Yasko J, Beck S, Guidelines for Oral Care, 2nd Edition, 1993, p.33. 2. Beck S, “Prevention and management of oral
complications in the cancer patient,” Current Issues in Cancer Nursing Practice Updates:Volume 1, Number 6.
11
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ORDERING INFORMATION
SINGLE USE ORAL SWAB SYSTEM
WITH PEROX-A-MINT® SOLUTION
2 Swabs with Sodium Bicarbonate,
Perox-A-Mint® Solution, and Mouth Moisturizer
100 systems/case
Reorder #6013-X
TOOTHETTE® PLUS ORAL
SWABS WITH SODIUM
BICARBONATE
Individually Wrapped
800/case
Reorder #6075-X
+1 815-455-4700
TOOTHETTE® PLUS
ORAL SWABS UNTREATED
Individually Wrapped
800/case
Reorder #6070-X
TOOTHETTE® ORAL SWABS
UNTREATED
Individually Wrapped
1000/case
Reorder #5602UT-X
MOUTH MOISTURIZER
ULTRA-SOFT TOOTHBRUSH
14g Tube
144/case
Reorder #6083-X
Individually Wrapped
72/case
Reorder #6082
2g Packet
1000/case
Reorder #6090
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SOURCE CONTROL
Controlling the source of microorganisms on
patients’ skin is a key component in reducing
transmission between patients, staff, visitors and
the healthcare environment.1,2 Patients at risk—
especially those known or suspected to be
colonized by resistant organisms—need a
practical and effective means to decolonize skin
to help prevent potentially fatal infections.
“People die from these infections—
which technically, almost
certainly, in many instances can
be prevented.”3
BENEFITS OF
CHLORHEXIDINE
GLUCONATE (CHG)
FOR “WHOLE-BODY”
DISINFECTION
REFERENCES
1. Bleasdale SC, et al., Skin Cleansing with 2% Chlorhexidine Gluconate (CHG): Infection Control and Clinical Benefits of Source Control. Presented at the 2006
Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Sep 2006, San Francisco, CA. Available at:
http://www.abstractsonline.com/viewer/viewAbstract.asp?CKey={0E71779A-4D5F-40B7-9DFA-1FEB439CCB23}&MKey={B9DB828F-3AAE-421F-8751A2D0757134CF}&AKey={32093528-52DC-4EBE-9D80-29DAD84C92CE}&SKey={65E88EE0-4D96-4063-87E7-9DC91BDDB99D}. 2. Vernon MO, et al., Arch
Intern Med. 13 Feb 2006;166:306-12. 3. ‘Superbug' infections spiralling in Canadian hospitals. Canadian Broadcasting Corporation (CBC) News. 23 Mar 2005,
Accessed 18 Sept 2006 at http://www.cbc.ca/story/canada/national/2005/03/21/infections-canada050321.html 4. Denton GW, Chlorhexidine. In Seymour S
Block (Ed.) Disinfection, Sterilization, and Preservation. 4th Ed., Lea & Febiger,Williams & Wilkins, Media PA, 1991:279. 5. Larson E, APIC guidelines for infection
control practice: guideline for use of topical antimicrobial agents. Am J Infect Control. 1988;16(6):253-65. 6. Edmiston C, Seabrook GR, Comparison of a new and
innovative 2% chlorhexidine gluconate (CHG) impregnated preparation cloth with the standard 4% CHG surgical skin preparation. Poster presented at the 2007
Association of periOperative Registered Nurses (AORN) Congress, Orlando FL, 2007 Mar. 7. Ryder M, et al., Improving Skin Antisepsis: 2% No-Rinse CHG Cloths
Improve Antiseptic Persistence on Patient Skin Over 4% CHG Rinse-Off Solution. Presented at Association for Professionals in Infection Control and Epidemiology
(APIC) June 2007. Available at: http://www.sageproducts.com/education/chgSymposiaPres.asp.
13
The use of CHG for whole-body
disinfection “…is a valuable adjunct to
existing antiseptic and aseptic measures that
will contribute toward a reduction in infections
caused by organisms derived from the
patient’s own skin.”4
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ANTISEPTIC BODY
CLEANSER
CHG antiseptic in a
premoistened washcloth
Antiseptic Body Cleanser delivers a clinically
effective, first-of-its-kind solution—2%
chlorhexidine gluconate (CHG) with the gentle
scrubbing action of a non-abrasive, textured
cloth. Each disposable washcloth rapidly reduces
bacteria on the skin that can cause infection.
“One of the most important attributes of
CHG is its persistence. It has strong
affinity for the skin, remaining
chemically active for at least 6 hours.
Indeed, it probably has the best
persistent effect of any agent currently
on the market.”5
2% CHG CLOTHS VS.
4% CHG6
“The antimicrobial effects from the 2% CHG
product persisted on the skin for a full 6 hours
after application.”
The non-abrasive, polyester cloth “…most likely
promotes a gentle exfoliation of skin cells that
allows for a more thorough antiseptic effect
immediately after application.”
The 2% CHG Antiseptic Body Cleansing Washcloth
was also “…easier to use because it required no
blotting or removal of excess CHG.”
NO-RINSE VS.
RINSE OFF CHG7
PROVEN RESULTS AGAINST VRE
In one study, 9-month findings for bathing with Antiseptic
Cleanser (2% CHG Cloths) resulted in the following findings:
“…bathing MICU patients with disposable cloths containing
2% chlorhexidine gluconate reduced the microbial density
of VRE on patients’ skin. This led to decreased contamination
of environmental surfaces and health care workers’ hands
and less frequent patient acquisition of VRE.”2
“Our findings support the use of source control as an
adjunctive infection control measure to reduce
transmission of VRE and potentially of other
epidemiologically important organisms that colonize the
skin of hospitalized patients, particularly in high-risk settings
such as ICUs.”2
+1 815-455-4700
In another study, the 2% no-rinse CHG cloths
were shown to improve antiseptic persistence on
patients’ skin over 4% rinse-off solution.
Researchers found...”the amount of CHG that
remains on the skin after a no-rinse application is
significantly higher than a CHG application that is
rinsed off. This is true despite the fact that the
rinse-off application has a higher concentration of
CHG (4%) than the no-rinse cloth (2%). This
finding indicates that most of the CHG is likely
rinsed off the skin during or after the application
of the product, leaving very little CHG on the skin.
This could contribute to the efficacy of the no-rinse
CHG cloths as compared to the rinse-off product.”
14
ANTISEPTIC BODY CLEANSING WASHCLOTHS
Antiseptic Body Cleansing Washcloths deliver
a unique, clinically effective, 2% CHG
solution with the gentle scrubbing action of a
non-abrasive, textured washcloth. By rapidly
reducing bacteria that can cause skin
infection—and providing persistent
antimicrobial effect against a wide variety of
microorganisms—Antiseptic Body Cleansing
Washcloths make it easier for facilities to
reduce bacteria on the skin.
• Proven effective against a wide range of
microorganisms.4 CHG provides a cumulative effect with
multiple applications.
• Helps reduce risk of transmitting microorganisms from
colonized patients to staff, other patients, visitors, and
surrounding environment.
• Alcohol-free.Won’t dry out skin like alcohol-based
antiseptics.
• No rinsing. Ensures consistent CHG coverage while
reducing mess and waste.
• Latex-free.
Covered under U.S. Patent No. 7,066,916. Other patents pending.
“Cleansing patients with chlorhexidinesaturated cloths is a simple, effective
strategy to reduce VRE contamination of
patients’ skin, the environment, and
healthcare workers’ hands and to
decrease patient acquisition of VRE.”1
1. Bleasdale SC, et al., Skin Cleansing with 2% Chlorhexidine Gluconate (CHG): Infection Control and Clinical Benefits of
Source Control. Presented at the 2006 Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Sep
2006, San Francisco, CA. Available at: http://www.abstractsonline.com/viewer/viewAbstract.asp?CKey={0E71779A-4D5F40B7-9DFA-1FEB439CCB23}&MKey={B9DB828F-3AAE-421F-8751-A2D0757134CF}&AKey={32093528-52DC-4EBE9D80-29DAD84C92CE}&SKey={65E88EE0-4D96-4063-87E7-9DC91BDDB99D}.
ORDERING INFORMATION
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ANTISEPTIC BODY
CLEANSING WASHCLOTHS
ANTISEPTIC BODY
CLEANSING WASHCLOTHS
2 washcloths/package
Washcloth size: 19cm x 19cm
6 washcloths/package
Washcloth size: 19cm x 19cm
96 packages/case
Reorder #9601-X
40 packages/case
Reorder #9602-X
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THE BASIN BATH
Source of contamination
The basin itself can be a reservoir of
contamination.1 The hospital water supply may
also be contaminated.2 Soap and water presents
multiple threats to skin integrity.3 Clearly, there
is a strong need to improve bathing for
bed-bound patients.
MISSED CHANCE FOR SKIN INSPECTIONS
Nearly half of all pressure ulcers develop in the
hospital.4 In high-risk patients, it can happen in a matter
of hours.5 And yet, stage I and II pressure ulcers—the
most nurse-sensitive skin injuries—are often not
documented.6 While non-licensed staff are often most
likely to administer bed baths, they may not be trained
to recognize changes in skin condition before they
progress. Each bath could be a missed opportunity to
inspect skin, communicate problem areas, and apply
preventative measures.
BASIN BATH WATER
TEST RESULTS1
Of basins tested containing soap and
water in a Boston hospital:
All samples positive for bacterial growth.
61% had counts >105 cfu/ml.
60.8% positive for gram-negative
bacteria.
Over 35% of samples with gramnegative bacteria had counts >105
cfu/ml.
Bath water, gloved hands and objects
handled by nurses during bathing tested
positive for S. aureus, including MRSA,
Acinetobacter sp., Pseudomonas sp., E.
coli and other organisms.
WATER: OVERLOOKED
PATHOGEN SOURCE
REFERENCES
1. Shannon RJ, et al., J Healthcare Safety, Compliance & Infection Control. Apr 1999;3(4):180-4. 2. Anaissie EJ, Penzak SR, Dignani C, Arch Intern Med. 8 Jul
2002;162(13):1483-92. 3. Bryant RA, Rolstad BS, Ost Wound Mgmt. June 2001;47(6):18-27. 4. Amlung SR, Miller WL, Bosley LM, Adv Skin Wound Care.
2001;14(6):297-301. 5. Folkedahl BA, Frantz R, Prevention of pressure ulcers. Iowa City IA: Univ of Iowa Gerontological Nursing Interventions Research
Center, Research Dissemination Core; May 2002. 6. Robinson C, et al., Ost Wound Mgmt. May 2003;49(5):44-51. 7. Clark AP, John LD, Clin Nurse Spec. MayJun 2006;20(3):119-23.
+1 815-455-4700
At least 29 studies incriminate the hospital
water system as the source of serious
waterborne nosocomial infections.2 One calls
it “…the most overlooked, important and
controllable source of nosocomial
pathogens.”2 Patient exposure occurs while
showering, bathing and drinking. Reports
recommend minimizing exposure to tap
water for all patients who are
immunocompromised, have fresh surgical
wounds, or are at higher risk for infections.2,7
16
A WORLD VIEW ON HOSPITAL
WATER CONTAMINATION
“QUADRUPLE THREAT”
TO SKIN INTEGRITY
GERMANY
According to one peer-reviewed paper,
“traditional bathing presents a quadruple
threat to the skin. The cleansers used are
often drying, remove resident bacteria, and
alter the skin’s pH. Washcloths are harsh and
rough….Hot water used for baths has a drying
effect on the skin. Finally, bathing is often
performed with an element of
force and friction as the
cloth is lathered up
with soap and the
skin rubbed in an
attempt to achieve
cleanliness.”6
In a study conducted in a surgical intensive care unit (SICU) and
12 peripheral wards, Pseudomonas aeruginosa “…was found in
150 of 259 (58%) tap water samples taken from patient rooms.”
As the study concluded, “tap water from faucets contaminated
with P. aeruginosa plays an important role in the propagation of
this pathogen among patients. A high number of transmissions
were shown to occur both from faucet to patient and from
patient to faucet.”1
ITALY
Hot water supplies were sampled
for one year in 11 private Italian
healthcare facilities. Four samples
at each facility included distribution
points near the water boiler and
inside the wards (taps and showers).
As the study found, “Legionellae were
recovered from all the water supplies in
question: Legionella spp. in 86.8% of
samples, L. pneumophila in 82.6% of samples.”2
As one report found, “due to difficulties in eradicating
Legionella from the water system, other sporadic
nosocomial cases were subsequently identified. The report
concluded that “once the water system is contaminated,
control of Legionella may be protracted, difficult, and
expensive, and cases of hospital-acquired legionnaires’
disease are likely to recur.”3
FRANCE
In a new wing of a teaching hospital in Tours, France, tests for
Legionella were negative for two years after routine water
sampling. In 2005, samples tested positive. Measures to
eradicate Legionella included replacing showerheads and
flexible pipes, descaling and treating pipes with chlorine, and
thermal shock to the central water system. Follow-up samples
tested positive. Two months later, another sample tested
positive. All eradication measures had to be performed again.4
POLAND
One hospital study found that, “…Legionella bacteria are
widespread in our environment.” As the study states, “those at
particular risk include older people, those treated for long
periods by antibiotics, immuno-compromised patients in
oncology and transplantology units, diabetics, smokers and
people with chronic respiratory tract infections. This is the
reason why the contamination of hot-water systems in hospitals
and nursing houses with Legionella is thought to be highly risky
for certain patients.”5
REFERENCES
1. Reuter S, et al., Analysis of transmission pathways of Pseudomonas aeruginosa between patients and tap water outlets. Crit Care Med. 2002;30(10):2222-28.
2. Legnani PP, et al., Legionella contamination of hospital water supplies: monitoring of private healthcare facilities in Bologna, Italy. J of Hosp Infect. 2002;50(3): 220223. 3. Borella A, et al., Surveillance of legionellosis within a hospital in northern Italy: May 1998 to September 1999. Euro Surveill. 1999;4(11):188-120. 4. van der
Mee-Marquet N, et al., Legionella anisa, a Possible Indicator of Water Contamination by Legionella pneumophila. J of Clin Microbiol. 2006 January; 44(1):56-59. 5. Pancer K, et
al.,The Influence of Contamination of a Hospital Hot-water System with Legionella pneumophila on Serum Antibody Production by Staff Members. Indoor and Built
Environment 2006; 15(1):105-109. 6. Bryant RA, Rolstad BS, Ost Wound Mgmt. June 2001;47(6):18-27. 7. O'Flynn J, Patient bath basins are a potential risk factor for
HAIs in acute care. Poster presented at APIC 2007, San Jose, CA, 2007 Jun. 8. Risk assessment & prevention of pressure ulcers (revised). Registered Nurses Association of
Ontario (RNAO),Toronto, Ontario, 2005 Mar (accessed 02-27-07 at: http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=7006&nbr=4215).
9. Larson EL, et al., Am J Crit Care. May 2004;13(3):235-41. 10. Meets standards set by the United States Pharmacopeia (USP). 11. McGuckin M, Shubin A,
Interventional patient hygiene (IPH): case study at the bedside. Poster presented at the American Professional Wound Care Association National (APWCA) Conference,
Philadelphia, PA, 2007 Apr. 12. Wickett RR,Visscher MO,Am J Infect Control. 2006 Dec; 34(10 Suppl):S98-S110.
17
BASINS OFTEN A
“NOSOCOMIAL
RESERVOIR”
The basin itself is also a proven carrier of
potential pathogens. In a study presented
at APIC 2007, 52% (13/25) of dry basins
were positive for organism growth.7 Of the
basins that showed growth, 62% (8/13)
demonstrated growth of multiple
organisms. Based on these findings, the
facility now uses prepackaged bathing
washcloths.
www.sageproductsglobal.com
COMFORT BATH®
The hygienic standard
Comfort Bath’s premoistened washcloths deliver
hygienic cleansing in one step. By eliminating
contamination risk from basins and tap water during
bathing, Comfort Bath also helps facilities comply with
Centers for Disease Control and prevention infection
control guidelines. Now Comfort Bath can help meet
recommendations of the Registered Nurses
Association of Ontario (RNAO) for skin assessment,
Comfort Bath
4.7 - 4.9 pH
Normal
Healthy Skin
Deodorant
Bar Soaps
4.5 - 5.5 pH
9.5 - 12.0 pH
documentation and promoting skin integrity.8
“The disposable bath is a desirable form of bathing
for patients who are unable to bathe themselves in
critical care and long-term care settings, and it may
even be preferable to the traditional basin bath.”9
PROVEN HYGIENIC, COST-EFFECTIVE
Comfort Bath’s formula contains only USP purified water.10
So you never have to worry about contaminated tap water
for bathing. By cleansing body areas separately, these
disposable washcloths also minimize cross-contamination. In
one study, Comfort Bath cleaned effectively—while offering
fewer opportunities to recontaminate skin.9 Comfort Bath
was also cost-competitive, took less time, required fewer
products, and “nurses expressed a clear and significant
preference for the disposable bath….”9
In one new study, cost alone spurred one facility to replace
Comfort Bath with the standard basin bath. In just 9 months,
the move was associated with a 92% increase in urinary
tract infections (UTIs) and over US$107,000 in additional
costs.11 Not surprisingly, the facility reinstated Comfort Bath
as the standard of care for bathing those who are bedbound.
+1 815-455-4700
Skin “…has a surface pH of approximately 4
to 5.5, and this acidic pH, the so-called ‘acid
mantle’ of the skin, may play a role in
protecting against colonization of the skin
surface by harmful bacteria.”12 Comfort Bath’s
pH mirrors that of healthy skin.
BASINLESS BATHING
BENEFITS
Helps improve skin integrity; better skin
care (one-step, full-body cleansing and
moisturizing)
Limits exposure to tap water
Improves patient and nurse satisfaction
Helps meet professional and regulatory
guidelines for quality and patient safety
Helps reduce process variation
Reduces linens and supplies for bathing
18
COMFORT BATH® |
Essential® Bath Cleansing Washcloths
Rinse-free, full-body cleansing and
moisturizing is available with or
without fragrance.
• High-quality, polyester
blend washcloths are
ultra-soft, yet very
durable.
• Generous amount of
rinse-free cleansers and
moisturizers to bathe
and soften skin.
• Dermatologist-tested
formula; proven
hypoallergenic, gentle
and non-irritating.
• Insulated, resealable packaging keeps washcloths warm.
• Latex free
ORDERING INFORMATION
19
FRAGRANCE-FREE
ESSENTIAL® BATH
FRAGRANCE-FREE
ESSENTIAL® BATH
5 washcloths/package
8 washcloths/package
84 packages/case
Reorder #7411-X
60 packages/case
Reorder #7803-X
ESSENTIAL® BATH
8 washcloths/package
60 packages/case
Reorder #7413-X
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COMFORT RINSE-FREE SHAMPOO CAP
Comfort Rinse-Free Shampoo Cap cleans and
softens hair without the mess and aggravation
of traditional methods.
• Fabric-lined cap is premoistened with a gentle, rinsefree shampoo and conditioner. Effectively removes gels,
blood, iodine and more to leave hair clean and fresh.
• Eliminates the need to move patients to running water.
• Eliminates mess, cleanup, and the need to change wet
bed linens.
• Enhances patient satisfaction. Helps nurses provide a
warm, soothing shampoo and improves the way
patients feel.
• Latex free
Comfort Personal Cleansing Warmer
Warms Essential Bath and Shampoo Cap for patient comfort.
CLEANS AND CONDITIONS IN MINUTES!
1
2
Place the Comfort Shampoo Cap on your
patient’s head and gently massage.
ORDERING INFORMATION
COMFORT RINSE-FREE
SHAMPOO CAP
1 cap/package
40 caps/case
Reorder #7409-X
+1 815-455-4700
28-COUNT WARMER
with “TAKE FIRST” indicator
14-COUNT WARMER
with “TAKE FIRST” indicator
1 each/case
1 each/case
#7945
#7944
CART
1 each/case
#7920
20
IncontinenceAssociated
Dermatitis (IAD)
WHAT IS INCONTINENCE-ASSOCIATED
DERMATITIS?
Expert consensus defines IAD as “an
inflammation of the skin that occurs when urine
or stool comes into contact with perineal or
perigenital skin.”1 IAD is often grouped with
pressure ulcers (PUs). However, “a pressure
ulcer is defined as any lesion caused by
IAD PREVALENCE
IN HOSPITALS
unrelieved pressure resulting in damage of
shear) or linear lesions (caused by a skin tear).”1
Studies at long-term care facilities report
IAD prevalence at 5.6% to 50%, while
incidence rates range from 3.4% to 25%.1
However, one study has addressed IAD in
acute care. As this 976-patient study found,
20.3% were incontinent.4,5 IAD prevalence
for incontinent patients was 54% at three
hospitals, affecting 11% of the general
patient population.4,5
THE NEED FOR CONSISTENT
BARRIER CREAMS
IAD AS A RISK FACTOR
underlying tissue.”2 Skin damage from PUs
occurs from the inside out. With IAD, the skin
injury starts on the surface and works inward.
Thus, “IAD should be distinguished from
wounds caused by differing etiologies, such as
full-thickness wounds (caused by pressure and
For incontinent patients, protecting skin is just as
important as cleansing and moisturizing.3 Yet traditional
methods require so many steps, barrier application is
often overlooked. The result is process variation—
administering inconsistent methods of care. Meanwhile,
failure to apply a barrier can lead to incontinenceassociated dermatitis (IAD). In one study, 54% of
incontinent patients suffered from IAD, while 21% had
two or more peri-skin injuries.4,5
REFERENCES
1. Gray M, et al., J Wound Ostomy Continence Nurs. 2007 Jan-Feb;34(1):45-54. 2. Getting started kit: prevent pressure ulcers, how-to guide. Protecting 5 Million
Lives From Harm Campaign, Institute for Healthcare Improvement. 2006 Dec. 3. Haugen V, Gastroenterology Nursing. 1997;20(3):87-90. 4. Gray M, LernerSelekof J, Junkin J, CE symposium in conjunction with the 2006 WOCN Conference, Minneapolis, MN, 2006 Jun. 5. Junkin J, Moore-Lisi G, Lerner-Selekof J,
What we don’t know can hurt us: pilot prevalence survey of incontinence and related perineal skin injury in acute care. Poster presented at the Clinical Symposium
on Advances in Skin and Wound Care (ASWC), Las Vegas, NV, 2005 Oct. 6. Media Backgrounder: Pressure Ulcers, Pressure Ulcer Awareness and Prevention
Program, Canadian Association of Wound Care,Toronto, 2006 Nov 18 (accessed 07-16-07 at http://www.preventpressureulcers.ca/media/media.html). 7.
Amlung SR, Miller WL, Bosley LM, Adv Skin & Wound Care. Nov/Dec 2001;14(6):297-301. 8. Maklebust J, Magnan MA, Adv Wound Care. Nov 1994;7(6):25,
27-8, 31-4 passim. 9. Keast DH, et al., Best practice recommendations for the prevention and treatment of pressure ulcers.Wound Care Canada. 2006;4(1):3143. 10. Pressure Ulcer Prevention in all Hospital and Home-care Settings. European Pressure Ulcer Advisory Panel : Review 7,2. (accessed 07-10-07 at
http://www.epuap.org/review7_2/page8.html). 11. Bennett G, et al.,The cost of pressure ulcers in the UK. Age and Ageing. 2004;33:230-235.
12. Robinson C, et al., Ost/Wound Mgmt. May 2003;49(5):44-51.
21
FOR PRESSURE ULCERS (PUs) AND
OTHER SKIN INJURIES
According to the Canadian Association
of Wound Care, up to 70% of PUs are
preventable.6
Almost half of all PUs form on the
sacrum (36.9%) and ischium (8.0%).7
“…Patients with fecal incontinence were
22 times more likely to have pressure
ulcers than patients without fecal
incontinence.”8
“…The odds of having a pressure ulcer
were 37.5 times greater in patients who
had both impaired mobility and fecal
incontinence than in patients who
had neither.”8
www.sageproductsglobal.com
IAD RISK FACTORS
Fecal incontinence, frequency of incontinence, poor
skin condition, pain, poor skin oxygenation, fever, and
compromised mobility have a statistically significant
correlation with IAD.1 Other significant risk factors
include double (urinary and fecal) incontinence and
tissue tolerance impairments.1 While moisture is the
principal factor, an alkaline pH also increases IAD risk.1,9
For patients with double incontinence, the alkaline pH
activates fecal enzymes, increasing the likelihood of
damage when exposed to intact skin.1,9
COSTLY CONSEQUENCES
NETHERLANDS, UK
IAD treatment costs are not yet known. However, they are
suspected to be grouped with costs for other skin injuries,
such as PUs.1 Recent European cost models indicate that
total PU costs may consume 1% (Netherlands) and 4%
(UK) of healthcare expenditure.10,11
UK
The total cost to heal PUs is £1.4 to £2.1 billion annually.11
Most of it is nurse time.11 Expected mean cost to heal one
ulcer is £1,064 for Grade 1, £4,402 for Grade 2, £7,313
for Grade 3, and £10,551 for Grade 4.11
CANADA
A 100-bed acute care facility with a PU prevalence of
25%, (national average), spends more than $750,000
annually to treat PUs.12
PRESSURE ULCER5
Located over a bony prominence.
Over coccyx (tailbone) or ischia (butt bones);
they are usually round or oval shaped.
Over sacrum, may be butterfly shaped or
oval if mostly on one side.
Well-defined edges—no satellite lesions.
PU PREVALENCE
IN HOSPITALS
EUROPE
A European Pressure Ulcer Advisory Panel pilot survey
found an overall PU prevalence of 18.1%. It included
5,947 patients from Belgium, Italy, Portugal, Sweden and
the UK.10 An estimated 412,000 people, mostly hospital
inpatients, develop a new PU annually in the UK.11
EUROPE, CANADA
Some countries have conducted their own PU prevalence
survey, including Germany (5.3 to 28.3%), Iceland
(8.9%), Italy (8.3%), Japan (5.1%), Netherlands (23.1%),
Spain (8%), and Canada (25%).10
IAD DUE TO CONTACT
WITH URINE OR FECES5
Location is where the skin lays in or on urine
or feces; not only over a bony prominence.
Early injury is bright red, then bright red
and weepy.
Post-acute skin is purplish and very dry,
peeling like a sunburn.
No satellite lesions unless also has fungal.
+1 815-455-4700
22
COMFORT SHIELD®
BARRIER CLOTHS
Delivering outcomes with proven
IAD prevention
COMPLIANCE IN EVERY PACKAGE.
PROTECTION IN EVERY CLOTH.
Barrier application is never overlooked with
Comfort Shield—the compliance is in the cloth!
Each premoistened, disposable cloth delivers
one-step perineal cleansing, moisturizing and
deodorizing—while treating and protecting skin
with dimethicone. All-in-one convenience
PROVEN IAD PREVENTION
eliminates process variation. So you can be sure
a barrier is applied every time. By simplifying and
standardizing care, Comfort Shield makes it
easier to treat and prevent IAD.
Clean, treat and protect—Comfort Shield’s
soft, skin-friendly cloths do
it all in just one step. So
barrier application is
REDUCTION
guaranteed. And when
in Incidence
skin stays protected, IAD
and other skin problems can be
prevented. In fact, one study’s
comprehensive pressure ulcer prevention
program—featuring Comfort Shield as the
exclusive skin protectant—improved
compliance and reduced sacral/buttock
pressure ulcers by 89%!1
89%
Another facility revised its Skin Breakdown
Prevention Protocol with
Six Sigma methodologies,
including Shield Barrier
REDUCTION
Cloths “…to help cleanse,
in Incidence
moisturize, deodorize, and
protect patients from perineal dermatitis
due to incontinence.” Their “Save Our Skin”
program decreased pressure ulcer
incidence by nearly 70%.2
70%
REFERENCES
1. Clever K, et al., Ost/Wound Mgmt. Dec 2002;48(12):60-7. 2. Courtney BA, Ruppman JB, Cooper HM, Nurs Manage. 2006 Apr;37(4):36,38,40 passim.
3. Sluser S, Consistency the key for treating severe perineal dermatitis due to incontinence. Poster presented at the Clinical Symposium on Advances in Skin and
Wound Care (ASWC), Las Vegas, NV, 2005 Oct. 4. Pressure Ulcer Prevention in all Hospital and Home-care Settings. European Pressure Ulcer Advisory Panel :
Review 7,2. (accessed 07-10-07 at http://www.epuap.org/review7_2/page8.html).
23
www.sageproductsglobal.com
EUROPEAN PRESSURE
ULCER ADVISORY PANEL
(EPUAP) PU Prevention/Treatment
Guidelines*,4
EUROPE
RISK ASSESSMENT TOOLS AND
RISK FACTORS
1. Goal: Identify ‘at risk’ individuals needing prevention
and the specific factors placing them at risk.
Assessment should be ongoing and frequency of
re-assessment should be dependent on change in the
patient’s condition with the environment.
2. Goal: Maintain and improve tissue tolerance to
pressure in order to prevent injury.
PROVEN OUTCOMES3
Find the source of excess moisture due to incontinence,
perspiration, or wound drainage and eliminate this,
where possible. When moisture cannot be controlled,
interventions that assist in preventing skin damage
should be used.
* In addition to other interventions. Based on one or more of the following
evidence: (1) results of one controlled trial, (2) results of at least two case
series/descriptive studies on pressure ulcers in humans, or (3) expert.
DAY 1
72-year-old Canadian patient with severely
excoriated, blistered skin and extreme pain
from incontinence.
DAY 4
After 3 days using Shield Barrier Cloths,
patient’s skin vastly improved; no discomfort.
+1 815-455-4700
24
COMFORT SHIELD ® |
Barrier Cloths
Incontinence is a significant risk factor for skin
breakdown.1 Research shows that by applying a
barrier after each incontinence episode, skin
breakdown can be reduced.2 Shield Barrier
Cloths with dimethicone help you provide
consistent patient care by applying an effective
barrier—every time they are used!
• 3% dimethicone
formula was proven
equivalent to traditional
tube barrier creams.3
• Helps “protect skin
from excessive moisture
and incontinence,” as
recommended by the
RNAO.4 Helps prevent
perineal dermatitis;
helps seal out wetness.
• Breathable, transparent dimethicone barrier makes skin
assessment easy without removal.
• Helps maximize compliance to your incontinence
care protocol. Delivers an effective barrier every time
it is used.
• Dermatologist-tested formula. Proven hypoallergenic,
gentle and non-irritating.5
1. Maklebust J, Magnan MA, Adv Wound Care. Nov 1994;7(6):25, 27-8, 31-4 passim. 2. Clever K, et al., Ost/Wound Mgmt. Dec
2002;48(12):60-7. 3. West DP, Northwestern Univ Dept of Dermatology, Chicago, IL, Feb 2000. 4. Risk assessment & prevention of
pressure ulcers (revised). Registered Nurses Association of Ontario (RNAO),Toronto, Ontario, 2005 Mar (accessed 02-27-07 at:
http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=7006&nbr=4215). 5. Scheman A,West DP, Northwestern Univ
Dept of Dermatology, Chicago, IL, 1998 May/Jun.
ORDERING INFORMATION
25
SHIELD BARRIER CLOTHS
SHIELD BARRIER CLOTHS
with Dimethicone
with Dimethicone
3-pack
easy-tear package
large size cloths
8-pack
peel and reseal package
large size cloths
90 packages/case
Reorder #7453-X
48 packages/case
Reorder #7905-X
www.sageproductsglobal.com
COMFORT SHIELD ® |
Barrier Station
• Helps meet Institute for Healthcare Improvement
(IHI) Five Million Lives Campaign
recommendations by keeping supplies at the
bedside of at-risk, incontinent patients.1
• Helps keep incontinence supplies separated from
visitors and items in patient’s room, including
medical equipment, food, drinks, personal items,
bed, tables, etc.
1. Getting started kit: prevent pressure ulcers, how-to guide. Protecting 5 Million Lives From Harm
Campaign, Institute for Healthcare Improvement. 2006 Dec.
KEEP SUPPLIES AT THE BEDSIDE
OF AT-RISK PATIENTS!
Helps meet U.S. IHI recommendations.
Mounts easily to any wall.
ORDERING INFORMATION
SHIELD BARRIER STATION
Station with Removable Adhesive Strips
for wall-mounting near the bedside
2 stations/case
Reorder #7599
+1 815-455-4700
26
ADVANCED HEEL
PROTECTION
PATIENTS AT RISK FOR HEEL
PRESSURE ULCERS
For patients who develop pressure ulcers,
impaired mobility is the most frequently
occurring risk factor at 87%.1 Over half suffer
from malnutrition and decreased mental status.1
Other risk factors include peripheral vascular
EUROPEAN PRESSURE ULCER
ADVISORY PANEL (EPUAP)
disease, diabetes mellitus, metastatic cancer,
PU PREVENTION/TREATMENT
GUIDELINES*,5
spinal cord injury, etc.1 While external pressure
causes decreased perfusion (blood flow), it can
also result from arteriole disease, diabetes,
circulatory problems, decreased hyperemic
response and age.2
DIABETES: ENEMY OF HEELS
Even “Least Risk” Patients Need Protection
According to one prevention guideline, “those who are
at significant risk may develop Stage I ulcers in less than
2 hours on a standard support surface.”3 Immobility is
the key. New research, presented at the 2006
Symposium on Advanced Wound Care, studied patients
hospitalized for hip fracture or total knee replacement
surgery over a two-year period. Of those who
developed Hospital-Associated Pressure Ulcers
(HAPUs), 91% had Braden scores in the “least risk”
category (18-15).4
SURGICAL PATIENTS ALSO AT RISK
For surgical patients, risk is increased while lying
immobile in pre-surgery, then continues during the
entire procedure and through post-op recovery.
Risk Assessment Tools and Risk Factors
1. Goal: Identify “at risk” individuals needing
prevention and the specific factors
placing them at risk. Assessment should
be ongoing and frequency of re-assessment
should be dependent on change in the
patient’s condition with the environment.
External Pressure and Support Surfaces
3. Goal: Protect against the adverse effects
of external mechanical forces; pressure,
friction and shear.
Correct positioning or devices such as
pillows or foam wedges should be used to
keep bony prominences (for example
knees, heels or ankles) from direct contact
with one another in accordance with a
written plan.
Managing Tissue Loads
Whenever possible avoid positioning
patients directly on a pressure ulcer or
directly on a bony prominence unless this
is contra-indicated by their general treatment
objectives, in which instance an adequate
pressure relieving device (e.g., an alternating
pressure device) should be used.
REFERENCES
1. Maklebust J, Magnan MA, Adv Wound Care. Nov 1994;7(6):25,27-8,31-4 passim. 2. Wong VK, Stotts NA, JWOCN. Jul 2003;30(4):191-8. 3. Folkedahl BA,
Frantz R, Prevention of pressure ulcers. Iowa City (IA): University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core;
May 2002. 4. Walsh J, DeOcampo M,Waggoner D, Keeping heels intact: evaluation of a protocol for prevention of facility-acquired heel pressure ulcers. Poster
presented at the Symposium on Advanced Wound Care, San Antonio,TX. Apr 2006. 5. Pressure Ulcer Prevention in all Hospital and Home-care Settings. European
Pressure Ulcer Advisory Panel : Review 7,2. (accessed 07-10-07 at http://www.epuap.org/review7_2/page8.html). 6. Loehne HB,Trial of heel pressure relieving
device proves efficacious in long term care facility: Leads to process improvement across continuum of care. Poster presented at the WOCN Annual Conference, Salt
Lake City UT, 2007 June. 7. Burda V, A successful heel ulcer prevention program resulting in 95% reduction of heel ulcer incidence. Poster presented at the
Symposium on Advanced Wound Care (SAWC),Tampa FL, 2007 April. 8. Pressure ulcer prevention begins with admission. Hospital Management. 2006 Sep 1
(accessed 03-09-07 at: http://www.hospitalmanagement.net/features/feature748/). 9. Garrett D, Intervention with a new heel protection device and silver
alginate dressing to prevent amputation of lower leg due to stage IV ulcer of the heel and malleolus. Case study conducted at Salem Village Nursing and
Rehabilitation Center, Joliet IL, Oct 2006.
27
www.sageproductsglobal.com
PREVALON™ HEEL
PROTECTOR
Extra Protection For At-Risk Heels
PROVEN AGAINST FACILITY-ACQUIRED
PRESSURE ULCERS (PUs)
PROVEN RESULTS AGAINST EXISTING
HEEL PRESSURE ULCERS9
A new 10-week Prevalon study, included a nursing home and a
hospital, achieved the following:6
Case study conducted at
Salem Village Nursing
BEFORE PREVALON
Two years of failure to heal
and Rehabilitation Center
(Joliet, IL U.S.) An
88-year-old male patient
was admitted with severe
contracture to his knee
and existing stage IV
AFTER PREVALON
2nd Month of Intervention
ulcer on the heel and
lateral malleolus. After
two years trying to heal
the ulcer without
success, clinicians
consulted with the patient’s
family regarding lower leg amputation.
Complete closure of wounds for one patient with multiple
PUs (due to friction/shear from thrashing in bed).
Progress and eventual complete closure for one patient with
Stage IV heel ulcers.
Prevalon “…is effective in the prevention and treatment of
heel pressure ulcers,” is well-received by staff and patients,
and is now used throughout a 746-bed system
(4 nursing homes, 6 hospitals, 10
other facilities).
95%
REDUCTION
in Heel PU
Incidence
In a year-long study at a 550-bed nursing home,
Prevalon helped achieve a 95% reduction (39
PUs to 2 PUs) in heel PU incidence.7
In a two-year study of patients who developed a facility-acquired
pressure ulcer after hip fracture or total knee replacement
surgery, 91% had Braden scores in the “least risk” category of
18-15.8 Of these, 43% were on the heel. As this study found,
incorporating heel PU prevention—with early, aggressive
implementation of Prevalon—reduces the rate of heel pressure
ulcers. In fact, “…no heel pressure FAPUs were attributed to the
intervention units during the study period.”
+1 815-455-4700
Risk Factors
Study Subjects Who Developed Heel FAPUs
Pressors
Hip Fx,
TKR
Low
Albumin
Hemiparesis
weakness
CVA
PVD
Diabetes
Total FA Heel PU patients
with risk factors
# FA heel PU patients with risk
factor in Braden Category 18-15
Facility-Acquired Heel Pressure Ulcers
Braden “At Risk” Category 18-15
After learning about Prevalon, nursing gained
approval to try two new interventions—Prevalon for
heel protection and silver alginate for wound
dressing. By the second month, the wound had
closed completely. Nursing continued using
Prevalon and the patient’s wound healed completely
and remained free of heel ulcers.
Presence of co-morbidity in study patients
who developed heel FAPUs
28
PREVALON™ |
Pressure-Relieving Heel Protector
Prevalon helps minimize pressure, friction and
shear on the feet, heels and ankles of your
non-ambulatory patients. By off-loading the heel,
it delivers total, continuous heel pressure relief.
It’s unique design also helps reduce the risk of
plantar flexion.
• Ambidextrous, universal size fits most patients.
• No sharp edges or irritating straps that can damage skin.
Ultra-soft, open-weave fabric breathes for good air circulation.
Works
with DVT
compression
devices.
Reduces foot rotation
inside the boot. Soft
comfort-grip interior
minimizes friction and
shear, while keeping
foot in proper position.
Easy to apply and stays on
patient’s foot. Stretch
panels adjust in seconds
for a secure, comfortable
fit. And now they’re
tethered to the boot for
easier reapplication.
Built-in pillow-style
cushioning provides
proven, familiar
support surface.
Tag helps clinicians
visualize how to
properly apply boot
to patient’s foot.
Helps reduce the risk
of plantar flexion.
Adjustable panel
delivers maximum
support to the bottom
of the foot.
Helps keep foot in an
upright position with its
pontoon bottom design.
29
Helps maintain patient’s
freedom of movement. New
durable, low-friction exterior
slides easily over bed sheets.
It’s constructed with strong,
ripstop nylon, the same
material used in parachutes
and outdoor gear.This
smooth outer covering repels
liquids and makes Prevalon
easy to wipe clean.
www.sageproductsglobal.com
FOOT AND LEG STABILIZER WEDGE
Non-ambulatory patients are at risk for other
lower leg complications in addition to heel
ulcers. The new Prevalon™ Foot and Leg
Stabilizer Wedge works with the Prevalon Heel
Protector to help maintain the upright position
of the foot, minimizing lateral foot and leg
rotation in the highest-risk patients.
• Helps reduce pressure on the lateral side of the leg,
including the peroneal nerve.
• Crush-resistant foam withstands weight and constant
pressure from patient’s leg.
The unprotected heel is susceptible to
pressure ulcers, skin tears, plantar flexion (foot
drop) and nerve damage
Heel Protector
11
Stabilizer Wedge
22
3
3
1
2
3
(inside out)
ORDERING INFORMATION
PREVALON™
™
PREVALON
Pressure-Relieving Heel Protector
+1 815-455-4700
Foot and Leg Stabilizer Wedge
1 universal-size heel protector/package
1 wedge for use with Prevalon heel
protector/package
8 packages/case
Reorder #7300-X
10 packages/case
Reorder #7350
30
Born from a core belief in prevention, Interventional Patient Hygiene (IPH) is a
nursing action plan focused on fortifying patients’ host defenses with
evidence-based care. By promoting
a return to the basics of nursing
care, our advanced patient hygiene
products and programs help
healthcare facilities improve clinical
outcomes by reducing adverse events.
THE INTERVENTIONAL
PATIENT HYGIENE
COMPANY
We are pioneering IPH with industryleading brands such as Q•Care®
systems from Toothette® oral care,
®
Sage Antiseptic Body Cleanser, Comfort Bath® full-body cleansing,
Comfort Shield® all-in-one incontinence care, and Prevalon™ pressure-relieving
heel protection. Our advanced products make it easier for busy clinicians to
deliver essential patient care.
ABOUT SAGE PRODUCTS, INC.
Since 1971, Sage Products has
developed innovative,
disposable healthcare products
trusted by leading healthcare
facilities worldwide. Our core
belief is in prevention—that
evidence-based interventions
will improve outcomes. Our goal is to help healthcare facilities improve patient
safety and outcomes by preventing healthcare-associated infections, skin
breakdown and other adverse nosocomial events.
Visit the Sage Products
International Education Website!
Developed exclusively for healthcare professionals around
the world, our new international website provides FREE
information that can help your facility improve care, including
Performance Improvement Plans, Evidence-Based Protocols,
Clinical Studies, Customizable Posters and more!
Customizable Programs For:
Reducing HAP/VAP Risk Factors
Reducing Threats to Skin Integrity
www.sageproductsglobal.com
Available in 9 languages!
Preventing Incontinence-Associated Dermatitis (IAD)
Preventing Heel Pressure Ulcers
Controlling a Source of Antibiotic-Resistant Organisms
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80012C © Sage Products Inc. 2007