From Good to Great to Built to Last: Creating a Lasting Passion for Pressure Ulcer Prevention and Management

PURPOSE: After analyzing our institutional data on pressure ulcers, we noted there were significant variations in the identification, treatment, and documentation of pressure ulcers.  The purpose of this session is to describe a plan that has consistently decreased our hospital-acquired pressure ulcer prevalence over the past four years as well as improve our documentation of pressure ulcers.

SUMMARY OF PRESENTATION: A multi-pronged approach was used to increase awareness and educate the staff in pressure ulcer identification, management and documentation.  An APN certified as a WOCN was charged with this initiative. Quarterly wound care management classes were provided, new pressure redistribution support surfaces were purchased for all medical-surgical and critical care beds, and evidence-based plans of care were implemented.  The biggest challenge however was influencing human behavior.  In order to change the culture, we found strength in numbers by developing unit-based wound care champions, and offering education to the medical residents.  The hospital’s performance improvement team and I became walking billboards, handing out staging cards to unsuspecting residents, physical therapists and anyone within earshot.  We had slowly ignited the passion of prevention and kept the fires burning with continued education through bedside consultation, formal classes, product fairs and monthly meetings. OUTCOMES:  As a result of our initiative, our prevalence went from 8.2% in 2005 to 3.0% in 2009 with the national average being 6.0%.  Our estimated cost avoidance to treat hospital-acquired pressure ulcers from 2005 to 2009 was $1,504,311.  Although our hospital has implemented many of the same techniques and strategies that other hospitals have, we believe that it is the contagious enthusiasm that we had ignited in our staff that has helped us sustain success.