Conducting and Organizing a Quarterly Pressure Ulcer Prevalence Study in a Large Hospital System

PURPOSE: To describe the process the Wound Ostomy Continence Nurse ( WOCN ) team developed to organize and conduct a one day pressure ulcer (PU) prevalence study with the assistance of RN’s and student nurses. BACKGROUND: A prevalence study is conducted quarterly to determine the rate of unit and hospital acquired pressure ulcer occurrence. The objective is to do a skin assessment for PUs and chart review on 600 adult patients hospital-wide. Coordination of 60 RN’s and student nurses to accurately assess, document and record the data on the large number of patients is a significant challenge. The process of organizing the prevalence study evolves over several surveys. It is demanding due to the volume of patients and number of team participants. A valid prevalence study relies on the accurate identification of  PUs and recording of the data. METHODOLOGY: The process of organizing the survey has involved: choosing dates and staging area for the survey day one year in advance; development and revision of forms for the entire survey process; securing and training participants; involving student nurses. The survey is conducted with 11 teams on 29 nursing units, preparation of data collection packets for each team prior to survey, and evaluation of the prevalence study process. IMPLICATIONS: Some of the challenges encountered have included: inconsistency of RN’s participating in the survey; last minute changes to the team assignments; limited resources to answer questions and validate findings on surveillance day; large volume of patients assessed in one day, limited time to perform record reviews to verify hospital or community occurrence of pressure ulcers. Student nurses find the study valuable to their education. DISCUSSION: Addressing ways to improve the organizational and educational challenges associated with the prevalence survey is challenging but vital to sustaining the integrity of the study.