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Use of a Visual Tool to Guide Appropriate Prevention, Early Identification and Treatment of Skin and Wounds in the Emergency Department
Background: Pressure ulcer prevention and skin assessment is increasingly important across the healthcare continuum. Evidence has shown that early identification and intervention for at-risk patients have a positive effect on pressure ulcer prevention. Furthermore, the Center for Medicare and Medicaid Services guidelines have spearheaded changes in healthcare by requiring documentation of pressure ulcers present on admission to ensure hospital reimbursement. Therefore, bringing skin-based awareness tools and protocols into a frequent entry point of hospital care is prudent. A wealth of information is available regarding implementation of pressure ulcer programs in the acute care setting, however, interventions aimed specifically toward the emergency room setting are lacking. Incorporating a routine skin and wound care nursing component into an already dynamic, complex environment is challenging. Data show that in order to successfully implement a new program, it must feature communication, education and visual cues tailored toward each specific discipline of the health care team.
Action: Along with various other actions employed to increase awareness of pressure ulcer prevention and skin assessment in the emergency department, the Wound Care Team created a visual tool to guide appropriate nursing actions for prevention, early identification and treatment of skin and wound conditions. The tool, adapted to the emergency department, incorporates recommended pressure ulcer prevention measures based upon the Braden© Scale score, in addition to providing simplified, evidence based interventions for various types of common skin and wound conditions.
Outcomes: Increased compliance with documentation of skin assessments and Braden Scores, earlier initiation of pressure ulcer prevention protocol, implementation of standardized, cost-effective treatment of common skin and wound conditions and increased staff satisfaction were all noted following the implementation of this visual tool.
Background: Pressure ulcer prevention and skin assessment is increasingly important across the healthcare continuum. Evidence has shown that early identification and intervention for at-risk patients have a positive effect on pressure ulcer prevention. Furthermore, the Center for Medicare and Medicaid Services guidelines have spearheaded changes in healthcare by requiring documentation of pressure ulcers present on admission to ensure hospital reimbursement. Therefore, bringing skin-based awareness tools and protocols into a frequent entry point of hospital care is prudent. A wealth of information is available regarding implementation of pressure ulcer programs in the acute care setting, however, interventions aimed specifically toward the emergency room setting are lacking. Incorporating a routine skin and wound care nursing component into an already dynamic, complex environment is challenging. Data show that in order to successfully implement a new program, it must feature communication, education and visual cues tailored toward each specific discipline of the health care team.
Action: Along with various other actions employed to increase awareness of pressure ulcer prevention and skin assessment in the emergency department, the Wound Care Team created a visual tool to guide appropriate nursing actions for prevention, early identification and treatment of skin and wound conditions. The tool, adapted to the emergency department, incorporates recommended pressure ulcer prevention measures based upon the Braden© Scale score, in addition to providing simplified, evidence based interventions for various types of common skin and wound conditions.
Outcomes: Increased compliance with documentation of skin assessments and Braden Scores, earlier initiation of pressure ulcer prevention protocol, implementation of standardized, cost-effective treatment of common skin and wound conditions and increased staff satisfaction were all noted following the implementation of this visual tool.