A Nurse-Driven Skin Saver Pilot Performance Improvement Project: Collecting and transforming data into quality

Introduction

Unit-based pressure ulcer prevention teams play a pivotal role in data collection and sustaining best practice ideas at the bedside. Three nurses on our telemetry unit who are members of the hospital’s Skin Saver team independently initiated a unit-based plan to collect data that would provide ideas about how to improve bedside care.

Objectives

After viewing this poster, the learner will be able to:

• Identify the value of unit-based teams
• identify the value of unit-based peer-to-peer education
• Define the benefit of unit prevalence rounds

Improvement Process

Patients with a Braden score of 18 or less were selected and their risk score was added to nurses daily handoff report. Weekly prevalence rounds were conducted by skin saver team members and wound nurse practitioner  to ensure correctness of documentation of pressure ulcers present on admission and all patient beds were inspected for unwarranted use of reusable underpads  and excessive or inappropriate use of incontinence briefs. Peer to peer education was done with the primary nurse and patient care associate at the time of the assessments to reinforce best practice guidelines.

Outcomes

• All discharged or transferred patients were free of unit-acquired pressure ulcer for duration of pilot project and present on admission pressure ulcers remained stable or improved.
• Usage of incontinence briefs and reusable incontinence pads decreased by 60%.
• The success of this project demonstrated the value of unit-based skin care nurse-driven improvements and resulted in an interest from other units to replicate this process.
• Enhanced RN-to patient care associate communication was facilitated by Skin Savers team members modeling the desired behavior during rounds.