Raising the Bar with Braden Assessment Rounds: Our Epoch Journey Toward Destination Zero

Raising the Bar with Braden Assessment Rounds: Our Epoch Journey Toward Destination Zero
Background

The facility recorded an increase in the prevalence and incidence of hospital-aquired pressure ulcers and recognized a need for improvement. Data showed 7 HAPUs in 2007 and 2 HAPUs in Q1 of 2008. Objective

The objective of this quality improvement project was to decrease the prevalence and incidence of hospital-aquired pressure ulcers (HAPUs) to zero and to promote skin integrity awareness that would ultimately improve patient outcomes and staff satisfaction/morale. Methods

The facility identified evidenced-based preventative measures to be implemented throughout their 59 bed medical/surgical unit:

·         Braden Assessment Rounds

·         Institute for Healthcare Improvement “SKIN bundle” elements were implemented for patients with a Braden score of 18 or less

·         Pumps providing alternating pressure therapy were applied to mattresses of at risk patients

·         A pressure redistribution overlay was used on gurney surfaces when transporting patients off unit (introduced in Jan. 2009)

·         Additional prevention products used such as protective barriers for incontinent patients and foam protectors for oxygen tubing

·         Patients were mobilized 3-4 times daily

·         Hourly rounding was implemented focusing on the 3 P’s – pain, potty, positioning

·         1:1 pressure ulcer prevention education was provided to nursing staff

·         Shift meetings twice daily to discuss prevention strategies, outcomes and successes. Results

As a result of the new preventative procedures, the facility reported zero HAPUs for 18 consecutive months. These improved outcomes also had a positive impact on the staff job satisfaction and morale. The nursing teams’ pride and sense of unity improved as well as their job satisfaction as both management and nursing staff shared a commitment to sustaining a safe patient environment. Conclusion

Implementing evidenced-based preventative measures can help decrease the prevalence and incidence of HAPUs and increase staff satisfaction/morale.