TI S SUE VIAB I L I T Y


for fast and easy pressure injury/ulcer risk assessments and acts as an adjunct to routine clinical skin assessment on the sacrum and heels. It is intended as an adjunct to current standard of care for the detection of deep and early-stage PI/PUs by healthcare professionals. The Provizio SEM scanner reports the level of biocapacitance of a tissue site as an ‘SEM value.’ A comparison of the SEM values at the inflamed tissue site with those from adjacent, healthy tissue sites will identify the maximum difference between the SEM values, which is called the ‘SEM- delta.19


The Provizio SEM Scanner consists of a pair of concentric coplanar electrodes, an integrated pressure sensor, software that computes a ‘delta’ value from a set of readings made around a common location, and a user interface device screen that displays the device status, battery status, the most recent reading, and the calculated delta value. Patients with a delta of < 0.6 at an anatomical site may suggest no indication of deep and early-stage PI/PUs: Patients with a delta of ≥ 0.6 at an anatomical site may suggest detection of deep and early stage PI/ PU.25


hospital acquired pressure injuries/ulcers (HAPI/Us) developed during the evaluation in this patient group.30 An evaluation, to compare the clinical utility of using a SEM Scanning device versus subjective visual skin inspection in the early detection of Category 1 PI/PU, reported 33% of patients who had no signs of visible damage had positive scan results indicative of underlying damage and that delta readings prompted front line staff to implement targeted interventions.31


Evidence suggests that the Provizio SEM Scanner is a cost-effective means of documenting PI/PU risk.31


Earlier


detection of deep and early-stage PI/PUs, enabling targeted interventions, can result in significant financial benefits and cost savings,32


and caregivers with the use of appropriate patient handling aids. This may include the use of friction reducing slide sheets and/or patient lifts and slings.


Conclusion


helping to reduce the cost of care, free up nursing hours, release bed days and increase return of investment.31, 32


Earlier interventions The ability to objectively alert to deep and early-stage PI/PU detection five days earlier*26


Patient risk assessments are performed


with the Provizio SEM Scanner before visible damage manifests at the skin surface.26 This technology, designed in collaboration with healthcare practitioners and researchers, objectively alerts clinicians to detect deep and early-stage PI/PU on specific anatomical areas of a patient’s body on admission and five days* earlier than visual skin assessment25 tone.26


regardless of skin


In a controlled clinical study the SEM Scanner demonstrated higher sensitivity of 87.5% compared to visual skin assessment (VSA) of pressure injuries/ulcers. In one study, pressure injury/ulcer


interventions guided by the readings from the Provizio SEM scanner, used adjunctively with standard care, reduced hospital-acquired pressure injuries/ulcers by up to 93%.27 A study, which aimed to prevent and reduce the number of pressure injuries/ulcers in a community setting, reported an incidence reduction during the study period of 26.9%.28 Another study reported that 91% of patients had delta values ≥0.6 indicating inflammatory changes that without intervention may have progressed to a PI/PU. Additionally, zero


Improving quality of care outcomes related to the prevention of PI/PUs remain high on national healthcare agendas across Ireland and the UK. While many strategies and initiatives have contributed to the reduction of PI/PUs, it remains a clinical burden with a humanitarian and financial impact. New insights into the damage cascade associated with the development of PI/ PUs results in clinical practice guideline recommendations to minimise the exposure to sustained tissue deformations and to target the biomarkers of early cell death for effective PI/PU prevention. The introduction of a clinically


than traditional more subjective


tools could suggest that earlier, targeted interventions can lead to improved outcomes. Patients with activity/mobility impairment are those at highest risk of developing a PI/ PU, due to inability to reposition themselves, leaving them exposed to prolonged, unrelieved pressure/shear over bony prominences.34


In the absence of mobility


and activity limitations, other risk factors should not result in a PI/PU.1


In addition to ensuring the correct support


surfaces to prevent PI/PUs, care intervention pathways such as the aSSKINg Bundle34 and national and international guidelines1,24 emphasise the need for regular turning and repositioning of patients to help prevent tissue damage.


Common repositioning activities, if not managed properly could contribute to PI/ PU development due to the increased shear and friction exerted on the skin. Appropriate equipment assists in moving the individual and reduces unintended drag.1


evidenced, guideline aligned objective early risk assessment sub-epidermal moisture measurement device which alerts to deep and early-stage PI/PU detection can enable the provision of earlier interventions. Empowering safe and effective mobility as a priority could result in supporting quality outcome improvement initiatives and lead to the reduction of harm.


(*Median)


References for this article are available upon request.


CSJ


Repositioning


is undertaken to reduce the duration and magnitude of pressure over vulnerable areas of the body, and to contribute to the patient’s comfort, hygiene, dignity and functional ability.1 Frequent repositioning in and out bed can be made easier and safer for both patients


In one study, pressure injury/ulcer interventions guided by the readings from the sub- epidermal moisture scanner, used adjunctively with standard care, reduced hospital-acquired pressure injuries/ulcers by up to 93%.


MAY 2021 About the author


Caroline Fallon is the clinical and training lead for pressure ulcer prevention and management and VTE at Arjo UKI. She is a qualified nurse who worked for many years in the NHS with specialist qualifications in Intensive care, orthopaedic and spinal injury nursing. She has worked for Arjo in various clinical roles since 2007 and is passionate about supporting patients, carers and healthcare organisations in promoting harm-free care and improving outcomes.


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