: Linking Skin Care with Safe Patient Handling to decrease Hospital Acquired Pressure Ulcers and Increase Patient and Staff safety

Focusing on the prevention of hospital acquired pressure ulcers at Carondelet St. Mary’s Hospital, Tucson, AZ   increased the number of repositioning tasks required by staff. An independent company survey conducted at our hospital in 2004 and again in 2007 indicated that the number of repositioning tasks more than doubled during that time frame. In addition, the dependency level of the patients for mobility also increased by 10%. Our patient population was more dependent and we were repositioning them more often; therefore increasing staff exposure to risk of injury.                The SKIN Bundle was implemented in 2006 to reduce hospital acquired pressure ulcers. The rate of hospital acquired pressure ulcers dropped from 4.4 % in 2004 to 0.4% in 2007 and continue to decline to 0% in 2009. However, the number of staff injuries related to repositioning has increased. Currently 43% of our patient handling injuries occurs during the task of repositioning. This led to a project with the Safe Patient Handling Coordinator and the WOCN to develop education targeting safely repositioning patients to prevent hospital acquired skin breakdown while decreasing the risk of injuries to staff.

The TOP Notch Program (Turn, Observe and Protect), was presented to the Patient Care Technicians in twenty minute in-services on the Patient Care Units. Education included who to turn, how to turn safely, what to observe and how to protect from a patient and staff safety perspective. Teaching on pressure redistribution, protective barrier ointment, and the use of friction reducing devices, in addition to the utilization of bed functions and teamwork was provided. We emphasized the importance of the role of the Patient Care Technician in observation, communication and appropriate documentation.