MICU Skin Integrity Rounds: Empowering the Staff Nurse and Improving Patient Outcomes

There are multiple types of skin impairments which develop in patients in the Intensive Care Unit Setting.  ICU Staff nurses in 750+ bed acute care facility have expressed a knowledge deficit in identifying and differentiating among types of skin impairments.  It is important for the staff nurse to understand the etiology of skin impairments, as this will direct the nursing plan of care in treating, and preventing additional skin impairments. The purpose of this performance improvement project is (1) to implement an interactive educational program utilizing weekly ICU Skin Integrity rounds.  (2) Benchmark prevalence of IAD, ongoing development and implementation of an IAD prevention bundle, to reduce the incidence of IAD and hospital acquired pressure ulcers. This will assist in the development of a systematic, evidence-based method for tracking and trending skin integrity issues in the ICU population.  The (8) week educational program will be intiated in January 2009, we hope that it will empower the staff nurse to:  identify and classify skin integrity issues according to etiology; implement EBP nursing strategies to prevent IAD, fungal rash, and pressure ulcers; improve communication and continuity of care involving prevention and treatment strategies. The outcomes will be measured by three separate methods:  (1) pre/post educational intervention survey of nurses evaluating their knowledge base on skin impairment differentiation, pressure ulcer staging, (2) IAD prevalence compared weekly to benchmark established prior to starting educational program, (3) Hospital acquired pressure ulcer prevalence and incidence rates pre-educational intervention and monthly times 6 months.