Direct cost of dressings for pressure ulcers in hospitalized patients

Lima, Antônio Fernandes Costa; Castilho, Valéria; Baptista, Cleide Maria Caetano; Rogenski, Noemi Marisa Brunet; Rogenski, Karin Emília

doi:10.1590/0034-7167.2016690212i

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Research • Rev. Bras. Enferm. 69 (2) • Mar-Apr 2016 • https://doi.org/10.1590/0034-7167.2016690212i copy

Direct cost of dressings for pressure ulcers in hospitalized patients

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to identify the average direct cost (ADC) on the direct labor (DL) for nurses and the consumption of materials and solutions used in performing dressings for pressure ulcers (PU) in hospitalized patients.

Methods:

case study, exploratory and descriptive case conducted in a teaching hospital. For six months, 228 dressings were performed for the treatment of PU patients. We calculated the cost by multiplying the time spent by nurses by the DL unit cost, adding to the cost of materials and solutions consumed.

Results:

the dressings ADC of PU corresponds to US$ 19.18 (PUs-category I); US$ 6.50 (PUs-category II); US$ 12.34 (PUs-category III); US$ 5.84 (PUs-category IV); US$ 9.52 (PUs-unclassifiable) and US$ 3.76 (PU suspected deep tissue injury).

Conclusion:

the methodology used can be reproduced in different hospital settings for the development of other studies to expand and complement the knowledge gained.

Key words:
Pressure Ulcer; Nursing Care; Nursing Service, Hospital; Costs and Cost Analysis; Nursing Administration Research

Observations	n	Average	SD	Median
Category I	20²²⁸	65.69	18.20	64
Category II	54²²⁸	66.00	18.80	71
Category III	16²²⁸	64.25	27.58	67
Category IV	56²²⁸	59.33	26.14	60
Unclassifiable	69²²⁸	71.25	8.48	71.5
Suspected deep tissue injury	13²²⁸	71.50	3.54	71.5

Classification	Materials and solutions
Pressure ulcers - Category I	- Water-activated dressing plate (hydrocolloid) 15 cm x 18 cm triangular edge, Essential Fatty Acids (EFA), extra thin hydrocolloid 10cm x 10cm, rayon bandage 20cm x 7cm, hydrocolloid 10cm x 10cm and white gauze sterile 15cmx10cm.
Pressure ulcers - Category II	- AGE, rayon bandage 7cm x 20cm, papain, white gauze sterile 15cmx10cm, extra thin hydrocolloid 10cm x 10cm, hydrocolloid10cm x 10cm, hydrocolloid 15cm x 18cm triangular edge and skin protective (barrier cream).
Pressure ulcers - Category III	- Papain, rayon bandage 7cm x 20cm, white gauze 15cm x 10cm sterile and skin protective (barrier cream).
Pressure ulcers - Category IV	- Rayon bandage 7cm x 20cm, white gauze 15cm x 10cm sterile, AGE, papain and curative compound silver 15cm x 15cm.
Pressure ulcers - Category - Unclassifiable	- Papain, bandage rayon 7cm x 20cm, white gauze sterile 15cmx10cm, skin protective (barrier cream), AGE, extra thin hydrocolloid bandage 10cm x 10cm, bandage rayon 7cm x 20cm, dressing hydrocolloid plate 10cm x 10cm and disposable scalpel.
Pressure ulcers- Category - Suspected of deep tissue injury	- Papain, AGE, rayon bandage 7cm x 20cm.

Observações		n	Average US$^* * Conversion rate: US$ 0.49/R$, based on the price of 29/06/2012, provided by the Central Bank of Brazil.	SD US$	Median US$	Minimum US$	Maximum US$
Pressure Ulcers- category I
	Direct labor cost for Nursing staff	20	2.95	3.55	1.69	0.42	16.86
	Cost of materials and solutions	20	16.23	12.97	8.04	0.28	30.45
Average Direct Cost -Total- Pressure Ulcers category I		20	19.18	11.80	23.46	1.78	37.88
Pressure Ulcers- category II
	Direct labor cost for Nursing staff	54	1.85	1.27	1.69	0.42	5.32
	Cost materials and solutions	54	4.65	7.37	2.08	0.49	29.70
Average Direct Cost -Total – Pressure Ulcers category II		54	6.50	7.68	8.30	1.98	35.34

Observações		n	Average US$^* * Conversion rate: US$ 0.49/R$, based on the price of 29/06/2012, provided by the Central Bank of Brazil.	SD US$	Median US$	Minimum US$	Maximum US$
Pressure Ulcers category III
	Direct labor cost for Nursing staff	16	8.20	7.11	3.80	0.59	21.27
	Cost of materials and solutions	16	4.14	6.29	2.33	1.29	27.36
Average Direct Cost – Total- Pressure Ulcers - category III		16	12.34	11.24	14.86	5.17	49.63
Pressure Ulcers - category IV
	Direct labor cost for Nursing staff	56	2.53	1.85	1.69	0.42	8.43
	Cost of materials and solutions	56	3.31	5.22	2.21	1.23	40.99
Average Direct Cost – Total- - Pressure Ulcers category IV		56	5.84	7.02	8.45	3.16	51.39

Observações		n	Average US$^* * Conversion rate: US$ 0.49/R$, based on the price of 29/06/2012, provided by the Central Bank of Brazil.	SD US$	Median US$	Minimum US$	Maximum US$
Pressure Ulcers - unclassifiable
	Direct labor cost for Nursing staff	69	4.80	4.32	3.19	0.42	29.70
	Cost of materials and solutions	69	4.72	4.53	2.71	0.34	19.68
Average Direct Cost – Total- Pressure Ulcers - unclassifiable		69	9.52	8.60	9.30	1.83	34.55
Suspected deep tissue injury
	Direct labor cost for Nursing staff	13	2.26	1.58	1.71	0.42	5.32
	Cost of materials and solutions	13	1.50	0.68	1.80	0.35	2.43
Average Direct Cost – Total - Suspected deep tissue injury		13	3.76	2.46	6.26	1.84	9.32

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[1] CORRESPONDING AUTHOR: Antônio Fernandes Costa Lima. E-mail: tonifer@usp.br