Reducing Hospital Acquired Pressure Ulcers (PU); A facility wide commitment in one year

A Community 500 bed urban hospital reduced HAPU prevalence within one year. The facility strives to provide optimal patient care providing quality health care on current evidence best practices as acheived Magnet status. Chart audits demonstrated the RN staff difficulty identifying PU’s, implementing prevention strategies and ability to follow protocols for patients at risk to develop PU’s. PU prevalence reduced after implementing strategies to 2.9%(2009) to 1.4%(2010). Methods to decrease prevalence included education, identifying patients at risk, multidisciplinary teams, increasing competencies, staff empowerment and developing and updating protocols.¹ Administration support was also a key factor in this endeavor. A WOCN Clinical Coordinator Department liaison role was developed. ² House wide RN & NA education included identifying patients at risk, CMS regulations, financial impact, legalities, prevention interventions, skin care products and appropriate use of linen. Electronic newsletters are sent to RN staff ongoing. Our Education department developed mandatory computer based competencies including accurate staging and relief devices. Educators presented Braden Scale scenarios as part of unit based competencies. The implementation of turn teams, new incontinence absorptions pads, education on use of bed pumps and elimination of baby powder/ bar soap added to success of determined best practices.³ Involvement of RN, RD, RT and PT staffs were included in the quarterly PU survey. Each member completes the NDNQI pressure ulcer staging module. Newly developed PU prevention education is included to the quarterly survey during which RN’s share success stories and unit education. New to the survey the WOCN confirms inter-reliability, assessment and provides immediate feedback reguarding HAPU’s identified on survey day.⁴ The hospital  HAPU 2010 decreased from 2.9% to 1.4%. Improvement attributed to the implementation of best practices, staff empowerment, hospital wide education and administration support. Multidisciplinary involvement and multiple methods reduced percentage of our facilities HAPU prevalence.

 

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