ICU Skin Care Team Pressure Ulcer Prevention Pilot: Assuming Leadership and Empowering Staff Nurses to Prevent and Reduce The Incidence of Hospital Acquired Pressure Ulcers

ABSTRACT

ICU Skin Care Team Pressure Ulcer Prevention Pilot:  Assuming Leadership and Empowering Staff Nurses to Prevent and Reduce the Incidence of Hospital Acquired Pressure Ulcers

 Purpose: 

A reduction in the incidence of hospital acquired pressure ulcers (HAPUs) remains a high priority in today’s health care arena. A review of 2 years of quarterly pressure ulcer prevalence data underscored the need for a more focused approach to reducing the incidence of HAPUs at our institution. Chart audits focused on wound documentation, risk assessment and pressure ulcer intervention demonstrated inconsistent and incomplete information. 

Objective:

Several reports highlight the benefits of creating a pressure ulcer prevention program utilizing direct care nurses as peer resources and clinical experts. The

6 month pilot tested the utility of using ICU Skin Care Team (SCT) Nurses as leaders in advancing staff knowledge and empowering them to reduce the incidence of HAPUs for patients in six critical care units.

Method:

Facilitated by a CWOCN, eight pilot nurses completed extensive training to serve as expert role models and leaders.  The pilot nurses participated in joint patient rounding, provided evidence based education on skin and wound assessment, documentation, pressure ulcer risk and interventions, and performed chart audits to evaluate progress.

Outcome:

Proposed goals of the pilot included improved utilization of skin care clinical experts and resources, increased staff knowledge of skin / wound management and pressure ulcer prevention, resulting in reduction of HAPUs. The outcomes were reflective of these goals with chart audits demonstrated progressive improvement in documentation of all identified areas.  Pressure ulcer prevalence studies indicated a significant decline in HAPUs for 2 successive quarters after the completion of the pilot. Staff nurse surveys indicated overwhelming satisfaction with the pilot study, identifying staff support and education as key factors while indicating an increased knowledge related to wound care.