Development of Unit-Based Skin Saver Teams Using REACT

The Problem
Registered nurses and certified nursing assistants often do not work well together as a coordinated team. The lack of clear communication, teamwork, and goals may result in less than optimal patient care.
Goals

The goals were (a) develop core unit-based teams consisting of nurses and nursing assistants acting as resources for pressure ulcer prevention and incontinence care (b) increase use of evidence-based practice pressure ulcer prevention guidelines and (c) enhance teamwork focused on excellent patient-centered care.

Team Building Basics - REACT
REACT is a teambuilding tool representing five core values that would allow healthcare teams to function efficiently with a focus on patient care and safety.  The core values are Respect, Empathy, Accountability, Communication, and Teamwork.
Process for Improvement
Registered nurses and nursing assistants attended a joint eight hour continuing education program. Topics discussed included, policy and procedure based on evidence-based practice guidelines, legal issues, hand-off reporting, pressure ulcer risk assessment, staging and documentation, and wound care formulary. Upon completion of the program participants were awarded special skin saver team pins and certificates.
Outcomes
·         Increased bedside staff participation in unit-based quality improvement initiatives related to pressure ulcer prevention and skin care for prevention of incontinence-associated skin breakdown.
·         Development of a multidisciplinary Pressure Ulcer Prevention Council to oversee policy and quality initiatives.
·         Implementation of unit-based diaper-free environments leading to decreased incontinence related skin breakdown
·         Increased administrative support for the continued education and development of skin saver members.