Creation of a Champions of Skin Integrity (CSI) team as a strategy to reduce hospital acquired pressure ulcers

Purpose: The identification of unit based champions is a key strategy in ongoing efforts to reduce the prevalence of hospital acquired pressure ulcers. Evidence based practice speaks to individual unit accountability for PU reduction. Our unit based committee started in 2003, needed reenergized and refocused. Nursing administration suppoerted elevating this group's responsibilities and accountablilities. Strategies including committed staff are crutical to improvements in care.

Objective: Nurse managers on each unit sought out staff that expressed interest in wound care and assigned them as their unit's rep. A letter of commitment was drafted to outline the responsibilities and is signed by each unit rep and the nursing leadership on their unit. this single step was pivotal in increasing accountability. Monthly meetings focused on prevalence study data collection, analysis, new product evaluation and education. A contest was held to select an appropriate name to complete the transition of the team from the pressure ulcer focus group to VCU Medical Center's own C.S.I. Team "Champions of Skin Integrity". The Wound Care Team Coordinator chairs this committee and has enthusiastically instilled a radical vision of reducing HAPU by 50% this year!

Outcomes: The results of these efforts are significant. Interventions were stratified based on the different components of the Braden score, new mattresses obtained, new skin care products were evaluated and obtained and collaboration with the OR was initiated. We have reduced the occurance of HAPU by 41%. Accountablility for reducing HAPU has been embraced by nursing at VCU Medical Center and is being lived out through the leadership of the individual members of the CSI team chamions on their units through education, role modeling, and spear heading changes to policy, process and practice.