A Case Study Examining the Beneficial Effect of the Dolphin Therapy Surface for a Community Patient

Introduction The ambition to move care out of hospitals has been on the policy agenda for years. The aim to stem rising levels of hospital activity by providing care in the community has seen ever increasing levels of complex patients cared for in the community setting.

There is a general consensus that care closer to home is better for patients. Hospital at home schemes – where patients are cared for in their own home rather than in a hospital setting – have consistently resulted in improved levels of patient satisfaction compared to ordinary care. Care is structured around the patient and is provided by the multidisciplinary team according to their needs1, 2.

The majority of a patient’s final year in life is spent at home and most people would choose to die at home. Increasingly people still die in hospital. These excessive numbers are due to; unresolved symptom control, breakdown in provision of home care provisions such as lack of nursing/ night sitters; and lack of support for carers3.

Many patients at end of life in the community are unable to obtain a comprehensive care package or the correct resources for their needs. Despite best efforts to deliver increased nursing care to this patient group, it is frequently impossible due to lack of nurses available. Patients nursed at home who have pressure ulcers are, for reasons stated above, are at higher risk of death from sepsis.

There is significant human suffering involved for people living with pressure ulcers. They have a huge impact on patients’ quality of life, with pain a feature of approximately 43% of cases4. Pressure ulcers in older patients are associated with a fivefold increase in mortality5.

If patients in the community need to be admitted to hospital there are significant incremental treatment costs. NICE clinical guideline 179 estimates the increased length of stay to be an average of 5-8 days per pressure ulcer. This results in overall incremental treatment cost for each pressure ulcer of £7,600 or £22,000 in ITU6.

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