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Simple Low Cost Interventions Yielding Extraordinary Outcomes
The Industry Today
• Centers for Disease Control (CDC)
• Center for Medicare/Medicaid Services (CMS)– POA 10/1/08
• Mandatory Reporting
• Institute for Healthcare Improvement (IHI)
• Consumerism
• Food and Drug Administration (FDA)
The Industry Today
• Infection tracking begins Oct. 1, 2007
• Reporting begins Oct. 1, 2008
• Pressure Ulcers
• Vascular and Urinary Tract Infections from catheters
• Mediastinitis
• Falls
• “Never Events”
• VAPs (2009)
Center for Medicare/Medicaid Services (CMS)Center for Medicare/Medicaid Services (CMS)
Source: Federal Register, Vol 72, No 162, August 22, 2007
The Challenges
Pressure Ulcers $30,0001
UTI’s $4,7002
SSI’s $25,5003
MRSA SSI’s $100,0004
VAP’s $40,0005
Hospital Acquired Infection (HAIs) Hospital Acquired Infection (HAIs) costs cited in the literaturecosts cited in the literature
(per event)(per event)
1. Amlung SR, et al, Adv Skin Wound Care, Nov/Dec 2001; 14(6):297-301. 2. Chen Yin-Yin, Chou Yi-Chang, Chou Pesus. Impact of nosocomial infection on the cost of illness and length of stay in intensive care units. Infection Control Hosp Epidemiology 2005; 26:281-7. 3. Stone PW, et al, Am J Infec Control. Nov 2005; 33(9): 501-9. 4. Engemann JJ, et al, Clin Infec Dis 1 March 2003; 36(5): 592-8. 5. Rello J, et al, Chest, Dec 2002; 122(6):2115-21.
The Sage Solution
• Fundamental belief in prevention versus treatment
• Simple, low cost interventions
• Documented success as Best Practice
• Focused effort
Bathing
Risk factors for HAI’s and Early
Detection of Skin Injury
Incontinence Care, Heel Floatation
Risk Factors for Pressure Ulcers
Oral Care
Risk factors for Hospital Acquired
Pneumonia
Preoperative Skin
Preparation
Risk of Surgical Site Infection
Interventional Patient Hygiene
The Sage Solution
• Second most common pressure ulcer1
• Many products on market are ineffective
• Proven outcomes in heel ulcer reduction2
Issue: Pressure Ulcers — Heels
1 Whittington KT, Briones R, Adv Skin Wound Care. Nov/Dec 2004; 17(9):490-42 Walsh JS, Plonczynski DJ, Journal of Wound, Ostomy & Continence Nursing. March/April 2007; 34(2):178-183
Cost of intervention: $100 per patient
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
The Sage SolutionIssue: Pressure Ulcers — Heels
• All-in-one approach to Incontinence Associated Dermatitis (IAD)
• Barrier solution inthe cloth
• Proven reduction in IAD of up to 62%
Driver S., Crit Care Nurse 2007 Aug: 27(4): 42-46
The Sage SolutionIssue: Skin Injury (Pressure Ulcers)
Cost per LOS for the patient with fecal incontinence: $12
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.
Issue: Skin Injury (Pressure Ulcers)
The Sage Solution
• Unique solution of 2% CHG lefton skin
• Documented reduction of MDROs
• Proven reduction in infections
The Sage SolutionIssue: Surgical Site Infections — MRSA
1 Prospective evaluation of six pre-operative cutaneous antiseptic regimens for prevention of surgical site infection, Poster presented at SHEA Conference, March 2006, Maki DG, Paulson DS. 2. Pre-operative Skin Preparation Protocol Results in Reduced SSI Rates, Rhee H, MD, Chair Infection Control Committee and Harris B, CIC, Infection Control Practitioner, Presented at Institute for Healthcare Improvement (IHI) Orlando, FL, December 2007.
Cost per patient per surgery: $5.50 per day
Issue: Surgical Site Infections — MRSA
The Sage Solution
• Comprehensive approach to oral care
• Market share leader1
• Five years of clinical success documenting dramatic reduction and even elimination of VAP2
The Sage SolutionIssue: Ventilator Associated Pneumonia (VAP)
1 Based on GHX market share data, 2007 Suction Oral Care and Non-Suction Oral Care categories2 Studies and symposia presentations found at http://www.sageproducts.com/education/vsymposiaPres.asp and http://www.sageproducts.com/education/varticles.asp
Average cost per patient in ICU: $100
Issue: Ventilator Associated Pneumonia (VAP)
The Sage Solution
Revenue PreservationPotential investment per ICU patient
Incontinence $12/stay
Prevalon Boot $100/pair
Comfort Bath $6/stay
CHG $11/stay
Oral Care $100/stay
TOTAL $229/stay*
* Assumes ICU average LOS 3.2 days. Additional $44.25./day after 3 days
Condition Cost per each Intervention Cost per intervention
Pressure Ulcers $30,000 per1 Comfort Shield $12/stay*
VAPs $40,000 per2 Oral Care $100/stay
UTIs $4,700 per3 Comfort Bath $6/stay
Heel Ulcers $30,000 per1 Prevalon $100/pr
MRSA SSIs $100,000 per4 CHG $11/stay
1. Amlung SR, et al, Adv Skin Wound Care, Nov/Dec 2001; 14(6):297-301. 2. Rello J, et al, Chest. 2002. Dec; 122 (6):2115-21. 3. Chen Yin-Yin et al, Infect Control and Epidem. March 2005; 26:281-7. 4. Engemann JJ, et al., Clin Infect Dis. 1 Mar 2003; 36(5): 592-3-8. * Assumes ICU average LOS 3.2 days.
Simple, low cost interventions
• Focus
• Educate
• Implement
• Measure
• Delivered Outcomes
Sage Commitment
Thank You For Your Time