"PUP (Pressure Ulcer Prevention)-A Team Approach"

Shands Jacksonville is a 695 bed academic, level I trauma center, affiliated with the University of Florida and Shands Healthcare System.  In Fall 2002, there was one CWOCN practicing in the facility.  That winter, an additional 2.2 FTEs were added and the CWOCN retired.  The idea of a Wound Care Team began.   The nurses hired had a varied background, but no formal wound care training. Their focus was assessment of existing wounds and making treatment recommendations.   In the spring of 2004, a System wide “PUP” team was formed with administrative and clinical staff to look at standardizing pressure ulcer policies and risk assessment throughout the Healthcare System.  At Shands Jacksonville, through evidence-based practice, administration recognized the importance of prevention as key to decreasing pressure ulcer prevalence.   Nursing had a vision to create a comprehensive team that would educate patients, families and staff in PUP.  By focusing on prevention, the goal was to reduce facility acquired pressure ulcer rates.  A CWOCN was added to the team as the Director and over the next 3 years, an additional 4.0 FTEs were hired.   Their pay grades, titles and job descriptions were changed to reflect the role they were now performing. They were required to obtain certification within a year, and the hospital reimbursed them for a review course and associated expenses.   Currently the Shands Jacksonville’s Wound Care Team, known hospital-wide as the “PUP Team,” is one of the largest in the area.  It is comprised of 8 nationally certified RNs.  Despite hard economic times, Shands Jacksonville fully supports the team as it recognizes the value of prevention and the team’s cost effectiveness.  Since the inception of the PUP team described above, we have reduced facility acquired pressure ulcers including Stage I from 8.7% (2005) to 3.4% (2009).