Opportunity: Policies and procedures were reviewed and revised to reflect the current acceptable standard of practice on wound assessment and treatment. Intense staff education on preventative skin care was mandated. We align our assessment process with new CMS guidelines and implemented new tools; Braden Score, PUSH, Daily Pressure Ulcer Monitoring. Weekly skin management meetings were initiated with nurse leaders to identify residents with wounds, those at risk and discuss preventative treatment.

Daily skin checks, barrier creams, heel and elbow protectors, chair cushions, bowel and bladder programs, dietary involvement, PT/OT for positioning techniques were reinforced through education. Additional dynamic mattresses were purchased or rented for residents within 24 hours if warranted. All static mattresses were replaced with new static pressure re-distribution mattresses. A CWON was hired to guide staff on wound prevention and appropriate wound treatments for maximum positive outcomes.

Outcomes: Within the first 6 months, our acquired pressure areas decreased from 17 to 6. Eight months later we were revisited by the State Survey Agency with a deficiency free outcome. Through our continued efforts we have achieved a corporate threshold of acquired pressure ulcers at 2% or less at our 300-bed facility. Despite the initial shock of our State Survey results that identified issues with our practice, the end results have been ongoing positive outcomes for our Residents. No financial support received.