It takes a TEAM: Utilization of St. Francis Hospital's Professional Nursing Practice Model (PNPM) in the Development and Implementation of S.K.I.N. Champions Prevalence Study Teams

The 5 Million lives campaign has brought about an increased awareness of the importance of implementing hospital quality initiatives which help prevent injury to patients and save lives.  As of October 1, 2008 Centers for Medicaid and Medicare (CMS) implemented a non-payment policy for hospital acquired pressure ulcers.  Pressure ulcer prevalence is a nursing quality indicator outlined by the National Database of Nursing Quality Indicators (NDNQI).  The collection and reporting of NDNQI data is a requirement for achieving the American Nurses Credentialing Center’s Magnet nursing certification. 

Purpose:  In 2008, the S.K.I.N. Champion Prevalence Study Team program was developed to improve patient safety by decreasing the incidence of hospital acquired pressure ulcers. At St. Francis Hospital, the patient is the center of the Professional Nursing Practice Model (PNPM).  The PNPM provides the framework for the S.K.I.N program, measuring its effectiveness by utilizing performance improvement principles.    S.K.I.N. Prevalence Teams are established specifically to conduct monthly pressure ulcer prevalence studies for an entire quarterly data collection period. Each team consists of Clinical Nurse Specialist, Clinical Nurse, and Ancillary staff.  The team begins each prevalence study day with 1 hr didactics, which includes data collection requirements.  The teams then proceeds to their assigned units and conducts pressure prevalence study, each day ends with 1hr post conference, for a total of 6 CEUs for participants.

Outcomes: Analysis of SFH overall hospital acquired pressure ulcer rates from 2008 Q1 through 2010 Q3 shows a steady linear decline in hospital acquired pressure ulcer rates.  SFH began 2008 Q1 at 8.19% of patients surveyed with a hospital acquired pressure ulcer.  Quarterly data demonstrates SFH has achieved a steady linear decline to 0.76% 2010 Q3.   The SFH quarterly hospital pressure ulcer rate has sustained a Hospital acquired pressure ulcer rate of less than 0.80% during four consecutive quarters.