Purpose: The investigators wanted to establish a baseline prevalence rate of pressure ulcers at our tertiary pediatric medical center on which to improve care, services and outcomes.  A prevalence survey will be repeated in one year to measure the impact of the interventions for improvement.

Methodology:  A one-day prevalence survey was conducted in January, 2007 to determine the presence of a pressure ulcer, stage, and whether the pressure ulcer was present on admission.  Inpatients on medical-surgical and critical care units were evaluated by nurses that had been trained by the hospital CWOCN.  Verbal agreement was obtained from the parent/guardian prior to the skin assessment.

Statistics:  The prevalence rate was determined by dividing the number of patients with pressure ulcers by the number of patients seen.

Results:  Of the 266 assessed, 22 had pressure ulcers for a prevalence rate of 10.7%.   Nineteen patients had a facility acquired pressure ulcer for a rate of 9.2%. 

Conclusions:  Our prevalence rate of 10.7% was considerably higher than the 3.3% national pediatric prevalence rate that was reported in 2006.  We developed a Pressure Ulcer Prevention Team that included four units with the highest unit prevalence rate.  These units were two critical care units, a ventilator dependent unit and the Rehabilitative unit.  We used evidenced-base practice to develop a bundle of interventions that the bedside nurses could implement with ease.  This included using the NPUAP Pressure Ulcer Prevention Points:  risk assessment; skin care; mechanical loading and support surfaces; and education.  The prevalence survey to be conducted in January, 2008 will allow the team to accurately measure the hospital's progress toward best practices in preventing pressure ulcers.