Reducing hospital acquired pressure ulcers: A collaborative approach

Objective:  To decrease the overall rate of hospital acquired pressure ulcers in hospital through education on risk assessment,  prevention protocols, and collaboration of skin team members, WOCN and nursing staff.

Design:  Tracking of retrospective documentation of monthly hospital acquired pressure ulcer rates for the past four fiscal years.

Setting:  A 238 bed rural tertiary Level II Trauma Center in Northeastern Penna.

Participants:  Patients with hospital acquired pressure ulcers from July 1, 2004- June 30, 2008 

Interventions:   Mentoring and mandatory education of nurses and care partners by skin Team members and WOCN regarding identification of at risk patients and implementation of prevention measures. Skin care team members attended quarterly team meetings, participated in quarterly prevalence studies, and participated in chart reviews and education. Evidenced based pressure ulcer prevention protocols and treatment protocols were implemented. This allowed nurses to enter the prevention or treatment of pressure ulcers. In January of 2006 a qualitative initiative called “Measurement Monday” was implemented to improve documentation of impaired skin with a designated day of the week for measurements. In January of 2007 a uniform documentation tool for impaired skin was implemented on the nursing units. In March of 2008 computerized epic documentation for electronic record was implemented. ressure ulcer rates also became part of the nursing managers’ report card and yearly goals. Discussion of pressure ulcer rates and measures to decrease rates were ongoing. Our Vice President of Nursing” and Chief Nursing Officer provided ongoing support for our prevention strategies and programs.

Results:   Incidence of hospital acquired pressure ulcers decreased yearly over the 4 years with an overall decrease of 46% from 2004-2008

Conclusion:    Reduction in incidence of hospital acquired pressure ulcers was achieved through pressure ulcer prevention measures, education and the collaborative approach of skin team members, WOCN, nurses, care partners, management and administration.