Stress Ulcer Prophylaxis – Daily Practice in a Medical Ward for Two Years

Abstract

Introduction: The prevention of stress ulcers (SU) is well established in intensive care units, however, recently, this practice
has been extended to medical wards, despite little evidence to
support it. Its implementation is based on the association of
various risk factors, however, studies show that 56 to 71% of
patients under SU prophylaxis in medical wards have no such
criteria.
Objective: With this reality in mind, a trial was developed with
the intent to create, apply and audit the implementation of a
SU prophylaxis protocol in an Internal Medicine ward, over two
years.
Material and Methods: To this end, after reviewing the criteria
for SU prophylaxis in medical patients in 2011, an audit was
performed without previous notice followed by training of the
clinical staff. In 2012 and 2013 new audits were carried out.
Results: From 2011 to 2012, a statistically significant improvement in the guidance of patients was identified (57.8% to 70%),
however, there was a statistically significant setback from 2012
to 2013 (52.5%).
Discussion: The contributing factors for the improvement seen
from the first to the second audit may have been the elaboration of the SU prophylaxis protocol along with staff training.
Such improvement was dissipated in the third audit, probably
because of the controversy that surrounds this subject and the
absence of new training activities.
Conclusion: This trial intends to remind that not all hospitalized
patients have criteria for SU prophylaxis and that is important
to define protocols adapted to the reality of each institution as
well as maintaining permanent staff training.