TOPIC: Even in the presence of evidence-based practice, it can be a challenge to convince practitioners and nursing staff to standardize staging, treatment and methods of prevention for pressure ulcer. The Grand River Hospital District is facing such a professional practice challenge.

PURPOSE: The heart of the project is quality of care, cost effective treatment and patient satisfaction. The Department of Quality Improvement, of which the CWOCN is a member, is establishing an integrated pressure ulcer prevention, documentation and treatment regimen for its two rural health clinics, critical access hospital and long-term care facility.

OBJECTIVE:  One of the first objectives will be identification of the need areas through data collection to search for intrinsic and extrinsic risk factors; prevalence and incidence of facility acquired pressure ulcers for a baseline number in the district. Education will focus on the demonstration of standardized practitioner and nursing admission pressure ulcer assessment and staging documentation, plus standardized regimens for pressure ulcer prevention and treatment. There is an invitation for team participation toward standardized decision tree methodologies, pre-printed protocols, documentation and resource examples. The integrated team includes physicians, nursing, physical therapy, materials management, the WOC nurse and nurse co-author with the support of a physician champion and Chief Executive Officer.  The second objective will be to measure outcomes in determination of cost-effective equipment, supply costs, clinically effective strategies as measured by constant monitoring of the documentation, selection of pressure redistribution devices and whether or not protocols have been followed. Concurrent education and support of the involved team members will need to occur in order to continue the momentum.                                                                                          

OUTCOMES:  The participants will have created a standardization of care for pressure ulcer assessment, documentation, and prevention protocols based on evidence-based care across the district continuum with the ultimate goal of patient satisfaction.