Making a Difference Through Nursing Research in the Prevention of Pressure Ulcers

The prevalence of hospital acquired pressure ulcers in critical care units is a national issue. There are proven interventions that are beneficial to the maintenance of skin integrity. Amongst these are turning and positioning, pressure redistribution surfaces, maintaining the head of the bed at no greater than 30 degrees, nutrition, perineal cleanser and moisture barriers. The premise of the Skin Care Bundle (SB) is to incorporate the necessary steps in nursing practice, and to prioritize these steps along with utilizing the power of redundancy. The implementation of the SB promoted teamwork within the hospital, as supportive personnel assist professional nurses with turning, positioning and basic comfort care measures.

The professional nurse is the champion of the SB, collaborating with the Interdisciplinary Team in relation to the implementation of the bundle. The SB has six important components and is an all or nothing approach.           

Prior to initiating the SB, a baseline data collection was conducted and included 62 CCU patients and was equal to 775 patient days. This daily data collection included 30 data points. The statistical analysis of the pre-bundle data resulted that patients were most clinically unstable did not acquired pressure ulcers, the 30.65% that did develop CCU acquired pressure ulcers were the patients awaiting placement. The CCU staff was educated on the SB and the bundle was implemented, 453 patients were evaluated daily which is equivalent to 4,607 patient days, this data collection included 36 data points. The incidence of CCU acquired pressure ulcers decreased to 4.86%. The SB has since been implemented hospital wide and the prevalence of hospital acquired pressure ulcers continues to decrease dramatically.