Stopping Pressure Ulcers On the Front Lines: Combating Pressure Ulcers Through Teaming with Assistive Personnel

Background: Patients at extremely high risk for pressure ulcers and those with multiple pressure ulcers comprise a large component of the patient population admitted to a 404 bed urban acute care academic hospital. Prevention of iatrogenic pressure ulcers is imperative to the delivery of safe quality cost effective care. Historically, assistive personnel were not included in education or acknowledged for of their role in preventing pressure ulcers.

 Purpose: To reduce prevalence of hospital acquired pressure ulcers through educating and empowering assistive personnel.

Objective: (1) To provide comprehensive education regarding hygiene, moisture management, and pressure ulcer prevention to unlicensed assistive personnel. (2) To empower assistive personnel regarding there pivotal role in pressure ulcer prevention.

Intervention: The WOC nurse team implemented a variety of activities to increase knowledge about pressure ulcer prevention and skin care as well as supporting the assistive personnel in their patient care role. WOC nurses began this process by providing education regarding hygiene, pressure ulcer prevention, and moisture management for all newly hired unlicensed assistive personnel. Next, a lunch and learn with unlicensed assistive personnel was held highlighting the importance of pressure ulcer prevention through proper re-positioning. This included hands on demonstration of re-positioning and use of assistive devices. At yearly PCA (patient care associate) competencies, there was mandatory education on moisture management and bathing. This time also included support for their role in pressure ulcer prevention. The PCA’s signed a poster committing to being skin champions.

Outcome:  The hospital pressure ulcer prevalence rate was reduced from 13% in the 4^th quarter of 2010 to 5% in the 3^rd quarter of 2011. Through the process of teaming with the PCAs, many have become active in the hospital skin care team and assist staff in the collection of pressure ulcer prevalence data.