Maintaining Skin Integrity: Raising the Standards of Care in Pediatrics

Maintaining skin integrity is a challenge in a 205-bed high acuity pediatric facility.  The challenges to maintaining skin integrity are a result of the many subspecialties and combination of inpatient and outpatient care.  Issues range from prevention of pressure ulcers under bony prominences to maintaining skin integrity during treatments and under equipment in both the short term and long term.  To best serve the pediatric population and satisfy the unique patient care needs, the specialized body of wound care nursing knowledge to maintain skin integrity in the pediatric population needs to be disseminated. 

There are challenges, which prohibit dissemination of wound care knowledge, which include access to monetary funds, time, and qualified personnel.  A survey among interested nurses identified specific barriers, which included availability of financial resources and the need to travel to access an accredited program for interested nurses. 

The organization made a commitment to overcoming these barriers. This required a collaborative approach between the hospital organization, accredited school of wound ostomy and continence, wound care department of the organization and the interested nurses.  As a result 14 nurses representing each pediatric specialty unit, major outpatient clinics and community are able to take the wound care program.  These nurses will remain at the bedside as a staff nurse and be champions for their area of practice. 

These nurses will be able to bring their body of knowledge for their specific area and combine it with the formal education of a Wound Care nurse. Through these efforts the organization will have 14 wound care nurses on staff in addition to the certified wound ostomy continence nurse.  Changes in practice will be measured through patient satisfaction, staff nurse satisfaction and rates of skin integrity compromise.