Keeping Pressure Ulcers at Bay

Keeping Pressure Ulcers at Bay

Purpose: Become more proactive in our practice of preventing pressure ulcers

Objective: Four-fold approach

1.      Established Pressure Ulcer Task Force to review standards of care and evidence based practice relating to pressure ulcer interventions, treatment, and skin care.

2.      Reviewed what our facility had in place and compared it to the evidence based practice to see if we were on track.

3.      Revised where needed and evaluated for effectiveness.

4.      Educated patient care providers to be more aware of the implications of pressure ulcers and strived to keep that awareness out front.

Outcome: The task force reviewed, revised, and implemented changes to patient care policies, care plans, admission database and modified risk score tool. The Braden Scale was adopted and interventions according to risk were developed. The WOCN established protocols were approved to allow nursing staff more autonomy. Static air products were trialed for ease of use and durability. We used the manufacturer support package as an opportunity for further decreasing pressure ulcer incidence.

Educational offerings to nursing staff were scheduled as competency to address major components including: skin assessments, risk factors, interventions, documentation, and skin care products. Other disciplines with direct patient care contact were in-serviced on static air product applications.

Physician education was provided by offering webinars for CME credits, and placing NPUAP guidelines for pressure ulcers at dictation areas.  We also communicated WOCN services to assist with pressure ulcer staging and plans of action.

Conclusion: Our Stage II pressure ulcer rates dropped from a high of 103 to a low of 18 in five year trial period. We believe this drop in HAPU was based upon our proactive approach to pressure ulcer education and prevention. A proactive approach to preventing Stage II pressure ulcers will prevent Stage III and IV.