The goal to significantly decreased the number of facility acquired pressure ulcers.

The start is the 2003 Pressure Ulcer Prevalence Study. This study indicated our Facility acquired pressure ulcers (FAPU) at 17.4% comparing the international average of 6.8%.

July 2003 the hospital hired a full time Wound Care RN to provide the background and the journey began. A thorough evaluation of the current practice was necessary.

Step I To begin skin and wound rounds on the high risk (Long Term Care, Rehab, ICU, and CCU) units. Weekly the Wound Nurse turned each patient, document any findings, and address the treatment and prevention recommendations. This first step became the basis that triggered the necessary changes.

Step II The formation of the Wound Committee to discuss the findings and construct a plan.

Step III To streamline supplies, eliminating the confusion of treatment selection and the addition of prevention products.

March 2004 the next prevalence study; reduced to 10.2% FAPU (international average of 7.7%). Improvement was obvious. However; changes were required to make it easier to obtain orders and initiate prevention. Therefore: The Wound Committee approved protocols and nurse discretion orders subsequently approved by the medical executive committee. Each nursing unit was in-serviced on requirements of skin inspection, documentation and treatment. Risk assessment and prevention protocols were addressed. The protocols matched the new policy and nurse discretion orders which now could be implemented without the need to wait for the physician to round. A poster hung on each unit; included photos of wounds and treatment suggestion along with prevention protocols. The documentation form was changed to include the risk score, interventions, and wound documentation; keeping information together.

Triumph of success with 2005 score of 1.7% FAPU.