Implementation of a Skin Care Assessment Nurse Team (S.C.A.N. Team)

In the summer of 2006 a Wound Ostomy Continence Nurse (WOCN) was hired to oversee the development and implementation of a pressure ulcer prevention program.  To implement the program the WOCN was to follow a policy, Reporting and Tracking of Pressure Ulcers put out by the Veterans Administration along with the IHI 5 Million Lives Campaign. In 2007 staff from all units assisted with prevalence studies and in  2008 the S.C.A.N. Team was formed to assist with the management and prevention of pressure ulcers.     Education on the VA policy and pressure ulcer staging for all nursing staff was initiated and completed in Fall 07.  Pressure ulcer prevalence studies began being conducted every 3-6 months to monitor community and hospital acquired pressure ulcers. The S.C.A.N. team meets monthly with meetings focusing on education, product review, policy review and the prevention and management of pressure ulcers. The team includes staff  from all nursing units  as well as outpatient clinics , community based and home based clinics and the community living center.  S.C.A.N. team assisted in the decision to purchase 14 ICU low air loss and pulmonary beds for the ICU and 10 specialty beds for the progressive care unit in 2008.  Quarterly prevalence studies beginning in Dec 2006 through present show a decrease in facility acquired pressure ulcers of 0-4% remaining below the national benchmark of 4-6 %.  Assessment and Prevention of Pressure Ulcers policy was written and implemented in April 2008. Digital wound photography was implemented in 2008 to assist in the  documentation of pressure ulcers. In Spring 2008 a bed fair was held to evaluate 5 mattresses to determine best ulcer prevention mattress for purchase for the medical- surgical and CLC units.  Implemented in 2008 was the National VA skin template with improvement made by my local VA by adding wound assessment guidelines (location, measurements, drainage, wound bed, surrounding skin, pain, and odor) and listing interventions for prevention and treatment with those patients that score a Braden risk of 18 or below. SCAN team assists with coverage for the WOCN during annual leave and sick leave.   S.C.A.N. was recognized as "Best Practice" by a VA internal survey visit in March 2009.