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The oncology patient poses a unique challenge for the WOC nurse. Due to their compromised health and many risk factors that accompany the cancer diagnosis the WOC nurse is faced with the battle of preventing pressure ulcers and skin related problems. The WOC nurse department at a comprehensive cancer facility developed a pathway to success for prevention of pressure ulcers. The process for pressure ulcer prevention and treatment has been in place for many years. Due to the increased national awareness of pressure ulcers, this process has been fine-tuned and enhanced.
The pathway to success began with identifying areas of weakness and building upon these areas. The areas identified are:
· Development: Policy and procedure is standardized and evidence-based. It is also available online for RN viewing.
· Education: A pressure ulcer prevention program was implemented to educate the entire RN/HCA staff. A Skin Care Team was also developed to improve pressure ulcer identification and prevention awareness at the unit level with the use of educated “skin care champions”.
· Performance/Feedback: Quality indicator reports which include incidence rates are disseminated monthly and quarterly to the nursing units, management, and the Quality Improvement Committee and are then posted on each individual unit and on the facility’s internal website.
· Assessment: The Braden Scale Risk Assessment was implemented congruent with the Nursing Flowsheet in the EMR. A thorough skin assessment is performed twice daily and documented.
· Prevention: Prevention measures are implemented on all patients according to policy and Braden Scale.
· Treatment: Recommendations are made by the WOC nurse and implemented by the primary nurse.
An algorithm parallel to facility policy was created to demonstrate the pathway necessary to achieve successful pressure ulcer prevention. The sharing of this process may assist other WOC nurses develop their own “Pathway to Success”.
The pathway to success began with identifying areas of weakness and building upon these areas. The areas identified are:
· Development: Policy and procedure is standardized and evidence-based. It is also available online for RN viewing.
· Education: A pressure ulcer prevention program was implemented to educate the entire RN/HCA staff. A Skin Care Team was also developed to improve pressure ulcer identification and prevention awareness at the unit level with the use of educated “skin care champions”.
· Performance/Feedback: Quality indicator reports which include incidence rates are disseminated monthly and quarterly to the nursing units, management, and the Quality Improvement Committee and are then posted on each individual unit and on the facility’s internal website.
· Assessment: The Braden Scale Risk Assessment was implemented congruent with the Nursing Flowsheet in the EMR. A thorough skin assessment is performed twice daily and documented.
· Prevention: Prevention measures are implemented on all patients according to policy and Braden Scale.
· Treatment: Recommendations are made by the WOC nurse and implemented by the primary nurse.
An algorithm parallel to facility policy was created to demonstrate the pathway necessary to achieve successful pressure ulcer prevention. The sharing of this process may assist other WOC nurses develop their own “Pathway to Success”.