Decreasing the Incidence of Hospital Acquired Pressure Ulcers in a Surgical Intensive Care Unit

Decreasing the Incidence of Hospital Acquired Pressure Ulcers in a Surgical Intensive Care Unit

With the new guidelines for reimbursement going into effect, hospital acquired pressure ulcers (HAPU) will not be reimbursed by payers.  In a recent release by the National Pressure Ulcer Advisory Panel, the expert panel agreed that not all pressure ulcers are avoidable; however we must make every attempt to reduce severity and avoid them where possible.  Several lessons learned in our surgical intensive care unit (SICU) have helped us decrease our incidence of HAPUs. First, we implemented weekly skin rounds with the clinical nurse specialist and the wound, ostomy, continence (WOC) nurse.  These rounds have identified a knowledge gap among the nursing staff on skin care products, bed therapy, use of lift and transfer devices. Second, we provided numerous inservices such as a “lunch and learn” regarding pressure ulcer prevention.  We also did additional inservicing on lift and transfer devices that can be utilized in the SICU. Individualized staff education occurs at the bedside during weekly skin rounds.  These efforts have led to improved staff awareness and compliance with skin care. Third, we implemented a pressure ulcer worksheet which allows for tracking and follow up and a general wound assessment guideline that the staff can use a reference was also developed.  Fourth, we have changed skin care products and pressure relieving surfaces to aide in the reduction of HAPUs.  As a result of these efforts, we have seen a decrease in the number of avoidable SICU acquired pressure ulcers.