Pressure ulcers in pediatric and and neonatal patients - increasing awareness and improving outcomes

Children’s and Women’s Nursing Services at the University of Iowa Children’s Hospital would like to submit "Pressure ulcers in pediatric and neonatal patients - increasing awareness and improving outcomes". This article will outline our recent journey into awareness about pediatric and neonatal pressure ulcers and subsequent improvements. Until we began participation in the NDNQI pressure ulcer quarterly skin survey, our children's hospital was naïve about the pressure ulcers our patients were experiencing. After completing the first pressure ulcer survey, it was clear that we had opportunity for improvement.

Using the Iowa Model of Evidence-Based Practice for Quality Improvement, we found both a knowledge trigger (national guidelines) and problem trigger (clinical presence of Stage 1, 2 and unstageable pressure ulcers).  With this new information and a dedication to improving patient care outcomes, we formed a small committee to assess staff knowledge level, develop evidence-based standards of care, and eliminate pressure ulcers. We have also worked to identify appropriate pressure ulcer risk assessment tools for our neonatal and our pediatric populations, explored and evaluated new products, identified barriers and needed resources for success, provided staff education and worked to increase the activity of a group of unit-based skin care experts. Through implementation of evidence-based care, monitoring outcomes and providing feedback, we have made great stride in our attempt to eliminate pressure ulcers in our patients.