The Pressure is on You

Background: Our facility’s current initiatives are aligned with the IHI 5 Million Lives Campaign, and has pledged to reduce nosocomial stage 2, 3, and 4 Pressure Ulcers (PU) by 50%. Our facility is also participating in VHA’s program as a Rapid Adoption Network (RAN) to strengthen our PU prevention program.

Problem: March 2008 Skin Prevalence survey revealed a steady increase in our PU prevalence rate.

Purpose: To reduce the number of nosocomial PU and improve skin care documentation and develop pressure ulcer prevention plans.

Objective: Initiatives were developed to improve skin care documentation, increase awareness of patients at risk for PU, and correlate Braden score to appropriate nursing intervention, and utilization of Skin Wound Assessment Report to engage staff in PU planning.

Methods: Staff education through traditional classroom, traveling carts, posters/emails, and one on one mentoring. Staff participation was encouraged through quizzes and prizes. Creation of a Skin Wound Assessment Report to identify patients at risk for PU was also instrumental in our program. Nursing leadership and CWOCN’s utilized the Skin Wound Assessment Report to assist nursing staff to develop individualized pressure ulcer prevention plans that targeted specific patient risk factors.

Outcomes: Skin prevalence results from Quarter 2 &3 have resulted in a decrease in nosocomial pressure ulcers.

Conclusion: A strong partnership between nursing leadership, CWOCN’s (certified wound ostomy continence nurses) and bedside nursing staff was critical to the success of this initiative.