With the prevalence of pressure ulcers not showing an appreciable decline in New Jersey and with mandatory reporting by hospitals of Stage 3 and 4 pressure ulcers, the New Jersey Hospital Association (NJHA) initiated a statewide collaborative focusing on reducing their incidence across multiple healthcare settings.

Method:

The theme of the NJHA Pressure Ulcer Collaborative was reflected in the phrase “NO ULCERS” : • Nutrition and fluids, • Observation, • Up and walking or turn & position, • Lift, don't drag, • Clean skin, • Elevate heels, • Risk assessment, • Support surfaces.

The goal is to reduce the incidence of pressure ulcers by 25%. Using the collaborative model developed by the Institute for Healthcare Improvement (IHI), expert faculty developed a “bundle” of best practices and provided education through learning sessions, monthly conference calls, a listserv and website.

Participating organizations submitted progress reports and data to NJHA . Additionally, knowledge concerning pressure ulcers was measured prior to each educational offering using a validated tool.

Results:

After months of sharing and implementing assessment strategies, preventive interventions identified as best practices by expert faculty and nursing/medical literature and improved coordination of care between settings, the NJHA Quality Institute was able to demonstrate a 30% reduction in pressure ulcer incidence across the reporting organizations. The educational programs and conference calls raised the knowledge level for all nurses in the collaborative.

Conclusions:

Reduction in pressure ulcer incidence can be achieved through a collaborative effort using education, action plans and monitoring of process measures and outcomes.