Voices from Behind the Curtains
April 2013
Jeanette Sandor RN, Legal Nurse Consultant, and Certified Life Coach shares stories of nursing home abuse and neglect and how to prevent it from happening to your loved one.


Pressure Ulcer Prevention Program: A Journey
September/October 2011
Barbara Delmore, Sarah Lebovits, Philip Baldock, Barbara Suggs, and Elizabeth Ayello describe their efforts to reduce heel pressure ulcers in their facility, which resulted in a decrease in heel pressure ulcer prevalence from 7.3% to 1.3% in 3 years.


An RCT to determine the effect of a heel elevation device in pressure ulcer prevention post-hip fracture
July 2011
A study (J. Donnelly, PhD., BSc (Hons) Health Studies, MCGI, RGN, ONC) published in the Journal of Wound Care (Vol 20, NO 7, July 2011) sets out to compare the differences between complete offloading and “standard care” in the prevention of heel pressure ulcers in post-hip fracture patients. The randomized control trial (RCT) was conducted in the fracture trauma unit of a major tertiary referral center in Belfast, Ireland.


Nationwide Frequency and Costs of Potentially Preventable Hospitalizations, 2006
H. Joanna Jiang, PhD., C. Allison Russo, M.P.H., and Marguerite L. Barrett, M.S. April 2009.
The Agency for Healthcare Research and Quality (AHRQ) H•Cup project (Healthcare Cost and Utilization) published a study in 2009 indicating that one out of every $10 hospitals spent in 2006 was spent on a preventable condition. The study notes that better ambulatory care, improved access to effective treatment, and more cooperation on the part of patients could have improved these statistics. The article emphasizes the importance of prevention especially in contrast to the costs of treatment.


The Doctor’s Guide To: Pressure Ulcers Prevention and Treatment
by Kenneth Wright, June 2011
The Mediscript Self-Help Guide for Pressure Ulcer Prevention and Treatment offers basic information useful for a myriad of healthcare professionals as well as for caregivers and patients. Helpful charts make this guide useful as well as informative.


JAMA Patient Page: Pressure Ulcers
June 2010
The JAMA Patient page uses illustrations and easy-to-understand language to provide patients and caregivers with an overview of pressure ulcers. Special care is given to describing the stages of skin breakdown along with how to prevent pressure ulcers at the heel, sacrum, elbow, and other vulnerable areas of the body.


Essential Insights On Treating Diabetic Heel Ulcers
By Desmond Bell, DPM, Podiatry Today, March 2010
Diabetic heel ulcers pose particular challenges in the way of treatment because so many factors can impact the patient and the patient’s healing process. With those challenges in mind, this article details wound bed preparation, key considerations like offloading, and how peripheral arterial disease may affect a patient’s ability to heal.


Heel Pressure Ulcers: A Poster Presented at AWMA 2010 by DM Systems, Inc.
March 2010
This poster offers an overview of the epidemiology, prevention, treatment, and costs of heel pressure ulcers. The poster was presented at an annual meeting of the Australian Wound Management Association.


A Comparison Between the Use of Intravenous Bags and the Heelift Suspension Boot
to Prevent Pressure Ulcers
 (74 KB PDF)
By Isabel Bales, RN/BSN/CWOCN
This experimental study compared the effectiveness of an intravenous bag with the Heelift® Suspension Boot in preventing heel pressure ulcers. The study is the first to examine the effectiveness of intravenous bags in the prevention of heel ulcers.


The Keys To Heel Pressure Ulcer Prevention (388 KB PDF)
October 2009
DM Systems surveyed wound care professionals at several different trade shows and conferences. Most notably, the respondents preferred heel offloading devices 6-1 over pillows.


Pressure ulcer treatment. Health care protocol.
Institute for Clinical Systems Improvement (ICSI). Pressure ulcer treatment. Health care protocol. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2008 Jan. 28 p. [36 references]
Heel Pressure Ulcer Guidelines for treatment from the National Guideline Clearinghouse, the US Department of Health & Human Services, and the Agency for Healthcare Research and Quality (AHRQ). The emphasis in these guidelines is on education for patients, caregivers, and family members because education is a key component of prevention. Significantly, the guidelines also focus on the importance of pressure ulcer prevention plans and protocols.

Proactive Assessment and Management of At-Risk Patients Reduces Pressure Ulcers and
Saves $11 Million Annually in Two-Hospital System

By Joan McInerney, RN-BC, MSN, CWOCN
NOTE: Reference on this Web site to any specific commercial products, process, service, manufacturer, company, or trademark does not constitute its endorsement or recommendation by the U.S. Government, HHS, or AHRQ.
January 2009

Over a 5-year period, the NCH Healthcare System implemented a pressure ulcer protocol that included risk assessment, patient monitoring, consultations for high-risk patients, and the use of Heelift® Suspension Boot to help prevent heel pressure ulcers. The two-hospital system reduced heel pressure ulcers significantly and saved $11 million annually.

Practice Recommendations for Preventing Heel Pressure Ulcers (576 KB PDF)
by Evonne Fowler, RN,CNS, CWOCN; Suzy Scott-Williams, MSN, RN, CWOCN; and
James B. McGuire, DPM, PT, CPed, CWS, FAPWC

October 2008
This detailed article by Evonne Fowler, et. al., details why pressure relief or offloading is the most significant key to preventing heel pressure ulcers, including the difference between heel protectors versus heel offloading devices. The article also analyzes the “total patient” approach to preventing heel ulcers.

Diabetic Skin Care 
September 2008
This article includes the epidemiology and pathogenesis of diabetes in addition to how to care for diabetic skin and how to prevent diabetic foot and heel ulcers.


York, PA USA newspaper – “Doctor: Neglect was cause of Lieben’s death” 
September 2008
The number and depth of pressure ulcers on the body of Bernadette Leiben helped prove the level of neglect Leiben suffered at the hands of her son and her daughter-in-law. Leiben died due to the lack of care she received.


Manchester, England U.K. newspaper – “Great-grandmother ‘died’ from ulcer”
September 2008
A family in Manchester, England charged that Florence Stanton, who had suffered a stroke, died in part because of a heel pressure ulcer that was not treated at her long-term care facility for over a month. The facility was charged with negligence but was not found guilty.


Earn CE Credits (fee required) while learning more about heel pressure ulcers (PrU) 
August 2008
The purpose of this exam is to prove that the reader fully comprehends heel pressure ulcer (PrU) risk, development, prevention, and treatment.


Independent Research Offers Insight on Heel Pressure Ulcer Prevalence, Prevention, and Treatment 
December 2007
This study, made available by DM Systems, Inc., compares trending in heel pressure ulcer prevalence in 2004 versus 2007. The study also examines how nurses adapted treatment and prevention protocols over the three-year period.

Penny Wise and Pound Foolish: Controlling the Cost of Heel Pressure Ulcers (36 KB PDF)
by Denis B. Drennan MD
In this article, Dr. Denis B. Drennan, DM Systems founder, establishes a formula for figuring a facility’s heel pressure ulcer costs. Dr. Drennan also makes the case that investing in heel pressure ulcer prevention is more economical than treating heel pressure ulcers.

NEW CMS Nursing Home Pressure Ulcer Guidelines (4.6 MB PDF)
(CMS Appendix PP Tag 314)
The objectives of this protocol are to determine if pressure ulcers are avoidable and to determine if a facility is doing an adequate job of working to prevent pressure ulcers.

Amputation versus Conservative Treatment of a Stage IV Pressure Ulcer (356 KB PDF)
by Nicole L. Sender RN, DNS, University Place Care Center, Tacoma, WA and
Linda Manning PT, CWS, Physiotherapy Associates, Lakewood, WA

The purpose of this study was to see if amputation could be prevented by using more conservative treatment methods. A multi-disciplinary team used several tools, including Heelift® Suspension Boot, to help prevent amputation of limbs injured by pressure ulcers.

Heelift® Suspension Boot Performance Evaluation (24 KB PDF)
by DM Systems, Inc.
This document summarizes years of Heelift® Suspension Boot evaluations from wound care professionals who carefully trialed the product.

Preventing Heel Ulcers in Hip Fracture Patients (104 KB PDF)
by Theda Bordner, MSN, RN
Hip fracture patients are particularly vulnerable to sacral and heel pressure ulcers because of a lack of mobility. In this study, hip fracture patients who were given Heelift® Suspension Boot to offload the heel did not develop any heel pressure ulcers.

by Denis B. Drennan MD
In this article, Dr. Denis B Drennan, founder of DM Systems, Inc., notes that an investment in effective heel offloading devices is a reliable way to help prevent painful and expensive heel pressure ulcers.

Heelift® Boots Plus Computers Save Heels (36 KB PDF)
by Joan A. McInerney, MSN, RN, BC, CWOCN and Sandra K. Wheeler, BSN, RN, CWOCN
NCH Healthcare System, Naples, FL

This post illustrates the reduction of heel pressure ulcer prevalence at the NCH Healthcare System in Naples, Florida. The two-hospital system created a multi-disciplinary team that focused on assessment, consultation, and heel pressure ulcer prevention. Use of Heelift® Suspension Boot was a key part of the new pressure ulcer protocol.