A new technology could be the answer to reducing pressure injuries in aged care homes.
Since mid-2019 the computer visioning technology PosiSense has been helping staff at St Sergius Aged Care to reposition residents in their beds on time, in order to avoid pressure injuries.
A small sensor attached to the ceiling above a resident’s bed tells nursing staff whether a resident needs to be repositioned, or if they have already repositioned themselves. The system is a welcome reminder for staff and means residents aren’t disturbed unnecessarily.
The current industry standard is to reposition residents every 2 hours, but there were still over 12 000 pressure injuries between July and September according to Australian government data. Pressure injury prevention is one of the areas the Council Assisting for the Royal Commission into Aged Care recommended for urgent review by 15 July 2021.
Now PosiSense is working with Brisbane’s Prince Charles Hospital and the CSIRO to gather data for a new repositioning standard. But beyond that, could repositioning management technology be the next step in reducing pressure injuries in aged care?
Aged Care Weekly had a chat with PosiSense CEO Vladimir Yuzhakov about what PosiSense could mean for the aged care industry.
“It’s not rocket science. It’s just that previous repositioning technology was not possible.“PosiSense CEO Vladimir Yuzhakov
What prompted you to develop PosiSense?
The intention behind the product in general was to prevent pressure injuries in aged care facilities. But we didn’t really know much about what kind of data we would be receiving, and how efficient our product would be. It’s very much uncharted territory.
In aged care globally there were no solutions around pressure injuries, no research around it, so we didn’t really know exactly what we would face. The only thing we knew was that pressure injuries were a big problem, because we were hearing it from healthcare professionals, hospitals and especially aged care.
Then we developed the product, and since we started using it in aged care facilities we’ve learned that different patients require different repositioning frequencies.
You trialled PosiSense at St Sergius Aged Care. What did the system show you about preventing pressure injuries?
We were able to see what was happening with each resident, especially at night when there are no caregivers around. And that’s where we saw cases where some patients required frequent repositions. Say, for example, they cannot move themselves at all. And it is very clear that in this case frequent repositioning is required.
But we also have seen that in the majority of cases, patients are able to move at least a little bit, there is some mobility. Most of them are not able to reposition themselves completely, but you can still see their ability to move.
There was an intuition that these people probably should require less frequent repositions. And for them, keeping them on that two-hour repositioning schedule would be an excessive disturbance.
“it’s almost inevitable that reposition management systems, whether PosiSense or the others, will be best practice globally.“
So the system highlighted that there needs to be more flexible, more individualised repositioning standards for people in aged care. How do you expect future standards to look?
If you talk to professionals, wound care managers or clinical directors in aged care facilities, it is a commonly understood idea that people require a different number of repositions. Some people may require very frequent repositions, less than two hours, while other residents or patients may require repetitions of basically six hours and beyond.
We have cases where patients demand to be repositioned not as frequently. We’ve had multiple cases like this where patients just for psychological reasons or because it creates discomfort to them, ask us to put them on, let’s say, a six-hour schedule. So they want to be repositioned only once in six hours. And they do not develop pressure injuries. With one exception, we have only one case where a patient requested less frequent repositioning and then he developed a pressure injury.
It’s important to mention here that we’re still talking about a fairly low data base. We don’t have millions of patient base data, so it would probably be incorrect to make statistical conclusions based on just a fairly limited number of data. We have managed to record just 25 000 repositions.
“IT’S NOT JUST ABOUT POSISENSE. IT’S ABOUT A REPOSITION MANAGEMENT SYSTEM. IT’S JUST THE IDEA THAT DIFFERENT PATIENTS HAVE TO BE REPOSITIONED DIFFERENTLY.“
Since your work with St Sergius, Prince Charles Hospital and the CSIRO have come on board. What are you working on with them?
The first devices were installed in February 2020, in the geriatric ward of Prince Charles Hospital. The project research is at ‘stage zero’ there, where we are testing the technological capability of the system.
The CSIRO joined us just recently. We’ve been in communication with them for quite a few years, but we have joined their research formally just recently.
Basically the system will be used to understand, to observe, to gather all the data about what is happening with a patient. So, the data will be collected (who is getting pressure injuries and who is not getting pressure injuries) and at the same time, we will have all the data about the repositions of the patients.
Then we will run a statistical model that will determine the period of repositions that is safe for different kinds of patients, in terms of avoiding pressure injuries. That data will be a foundation for a statistical analysis to develop a new repositioning standard.
How far off do you think a new repositioning standard will be?
We hope that we will have the foundation – which is the data – in about a year. In reality it probably will be longer than that just because this has never been done before. It probably will be maybe a year and a half.
In the meantime, PosiSense has shown that individuals have very different repositioning needs. Will that mean that systems like PosiSense will play a key role in future practice regardless of new standards?
Probably I will help our competitors a little bit here. But it’s not just about PosiSense. It’s about a reposition management system. It’s just the idea that different patients have to be repositioned differently. And that nurses and aged care staff have to be assisted in this process to be reminded to reposition a person.
It’s common sense. It’s not rocket science. It’s just that previous repositioning technology was not possible. It’s only the development of computer vision technology that enabled this breakthrough. If you ask my personal opinion, it’s almost inevitable that reposition management systems – whether PosiSense or the others – will be best practice globally.
And we already see competitors appearing. Not in Australia, but globally, although not many yet. But it is an inevitable trend that reposition management systems will be best practice in most of aged care and in hospital settings.
Best of luck with it, Vladimir!