PURPOSE:  With an increasing focus by legislative and regulatory agencies for the prevention and treatment of skin and wound care issues, acute care facilities have been endeavoring to deliver appropriate preventative and treatment interventions.  Recognizing the improvements necessary to meet current guidelines, a multidisciplinary effort was begun to reduce prevalence of facility acquired pressure ulcers and provide an evidence based disease specific standard of care.

 METHODS:   Reviews of quarterly prevalence studies and monthly logs were used to establish baselines.   Policies were revised, product formulary was reevaluated, teams were brought together and educated and documentations records were developed.  A multidisciplinary team of Physicians, Nurse Practitioners, Registered Nurses, Personal Care Assistants (PCAs), Dieticians, and Physical Therapists met bi-monthly to identify issues and plan project improvements.  Consideration of federal, state, and local regulations as well as health economic issues was incorporated into the revisions.

 RESULTS:   Hospital wide staff education through the use of the Intranet system, creation and implementation of new documentation forms and reference material, and implementation of unit based Resource Nurses and PCAs have resulted in a 20% reduction in facility acquired prevalence in one year.

 DISCUSSION/CONCLUSION:    Many changes were implemented including the creation of new wound care assessment and treatment forms, establishment of a multidisciplinary wound care task force involved in the formulation of disease specific guidelines, the design of on-going educational programs for the nursing staff, and the design of patient and family educational material.  This effort, supported by hospital administration, will continue.