Jody Scardillo, MS, RN, CWOCN, Albany Medical Center, Clinical Nurse Specialist, 43 New Scotland Ave, Albany, NY 12208, Linda Hannan, MS, RN, CCRN, Albany Medical Center, Clinical Nurse Specialist, Surgical Intensive Care Unit, 43 New Scotland Ave, Albany, NY 12208, Mary Maskell-Amirault, MS, RN, CNS, CCRN, Albany Medical Center MC-73, Clinical Nurse Specialist, Surgical Intensive Care Unit, 43 New Scotland Ave, Albany, NY 12208, Karen Sigond, BSN, RN, Albany Medical Center, Nurse Manager, Medical Intensive Care Unit, MC -73, 43 New Scotland Ave, Albany, NY 12208, Lisa St. James, BSN, RN, Albany Medical Center, Assistant Nurse Manager, Medical Intensive Care Unit, MC-73, 43 New Scotland Ave, Albany,, NY 12208, Kathy Wise, RN, Albany Medical Center MC-73, RN, Medical Intensive Care Unit, 43 New Scotland Ave, Albany, NY 12208, Lyn Labarre, MS, RN, Albany Medical Center, Patient Care Service Director, Critical Care, Specialty & Emergency Services, 43 New Scotland Ave, Albany, NY 12208, and Catherine Vaughan, RN, Albany Medical Center, Assistant Nurse Manager, Surgical Intensive Care Unit, 43 New Scotland Ave, Albany, NY 12208.
A pressure ulcer prevention initiative was undertaken in the SICU and MICU of a tertiary care Level I trauma facility. After reviewing the literature for best practices and clinical guidelines, significant changes in practice were made. Despite all this, accurate and timely pressure ulcer documentation continued to be a problem. Barriers to documentation compliance include complexity of wounds and skin care needs of the critically ill patient and difficulty in describing these wounds using the written word. A plan was developed to include an image from digital photography to our twice-weekly wound documentation. Collaboration occurred with Risk Management, Nursing administration, and Information Services. Subsequently the nursing skin integrity management protocol was amended to encompass practice changes.
A KodakŪ digital camera system with docking station was purchased; a procedure was developed and trialed with feedback from clinicians at the bedside. As the nurse performs wound assessment, a digital photo is taken with paper ruler placed near the wound. Medical record number and date are used as the identifier. Strategies were developed to ensure consistency between photographers. The photo is printed and mounted on the wound photography documentation sheet then deleted from the camera to maintain patient confidentiality. Monitoring after implementation of the change monitoring showed an improvement in documentation quality. Other benefits of the program have included enhanced communication between nurses during shift-to-shift report, and unit-to-unit transfers. It has improved ability to monitor wound status despite different nurses caring for the patient. This has enabled more timely intervention as wound status changes occur. Future plans include rolling this out to the remaining adult critical care units and eventual incorporation of digital imaging into the electronic health record.
See more of Practice Innovation Poster Abstracts
See more of Practice Innovation Abstracts
See more of The WOCN Society 39th Annual Conference (June 9 -- 13, 2007)
