Improving Pressure Ulcers: Skin Wound Assessment Team (SWAT)

A multidisciplinary committee was developed to standardize and improve wound care in support of nursing care excellence and improved patient outcomes. The skin wound assessment team (SWAT) was formed through this committee to evaluate and recommend treatments for our complicated wound care patients. The SWAT and the monthly wound care committee work hand in hand in evaluating wound care processes, protocols and unit specific improvements throughout the facility.

Purpose:  The purpose of this analysis is twofold: one, to demonstrate improvement in patient outcomes through the use of a multidisciplinary approach to wound care; and two, to evaluate and implement protocols throughout the facility for process improvement and overall cost savings to the institution as driven by improvements in patient outcomes.

Methods:  The SWAT team rounds once weekly. The focus may be patient, unit or problem specific. Clinical processes are then reviewed and updated through the multidisciplinary care team’s monthly meetings. There is a focus on staff education at all levels during SWAT rounds.  

Results:  As a result of this multidisciplinary approach to patient assessment, significant improvement in patient outcomes, standardization of care and implementation of new care practices has occurred. The overall incidence of facility acquired pressure ulcers was reduced, both in number and severity of staging. Quarterly prevalence studies were reduced to 0.9% and 2% for the last two quarters of FY09 and 1.5% for the first quarter of FY10.  Implementation of new protocols such as our tracheostomy care guidelines eliminated all pressure wounds related to tracheostomy devices.

Conclusions:  The use of SWAT rounds along with standardized processes, education and quality nursing care improved patient outcomes for AMH while reducing costs of nosocomial pressure ulcers.  These improvements have been sustained for one year which demonstrates that a multidisciplinary approach to pressure ulcers affords quality patient care.