Lou Ann L. Rau, RN, BSN, CWOCN, Johns Hopkins Home Care Group, Staff Education Specialist/WOCN, 2400 Broening Highway, Baltimore, MD 21224 and Sharon Brady, RN, BSN, CWOCN, Hanover Hospital, Director of Wound Care Services, 300 Highland Ave, Hanover, PA 17331.
Problem: Through interdepartmental communication it
was discovered that a variety of skin care and non-skin care products were
being used to bathe patients and protect their skin, across the continuum of
care in a major metropolitan hospital system. Several of the products
being used included less than optimal cleansers, ineffective moisturizers and
barrier creams. Additionally there was no oversight of the proper choice
and/or use of these products for patients. It was also discovered that the
procurement process for skin care products was not consistent and there was a
lack of knowledge regarding the purchasing process by the WOC nurses.
Goals:
1. Develop a skin care protocol for the maintenance of
skin health and the prevention of pressure ulcers that would meet the needs of
the patient population in all care settings.
2. Educate
the WOC nurse to the purchasing process.
Process:
A task force of WOC nurses throughout the inpatient and home
care was convened to tackle these problems. Of consideration was:
- Best choice of product for
- Cleansing
- Moisturizing
- Protectants
- Evidenced based product selection
- Best price/performance
- Education of patient and staff
- Proper usage
- Product size
- Vendor support for education
- Special patient population needs
- Neonatal
- Pediatrics
- Oncology
- Transplants
- Product trials to establish best choice
Barriers to success were identified as:
·
Consensus for product use
·
Resistance to change
·
Understanding the purchasing process by the WOC
nurses
·
Understanding the care needs by the purchasing
department
