FAST HUGS rounds drive pressure ulcer prevention program

FAST HUGS rounds drive pressure ulcer prevention

The concept of the FAST HUG mnemonic  was introduced to critical care in 2005 by Dr. Jean-Louis Vincent, MD, PhD, FCCM in his article “Give your patient a fast hug (at least) once a day”(1).  Daily rounds at the bedside have been shown to improve ICU patient outcomes.  With multidisciplinary involvement, all members of the care team can question the various aspects of the patient’s care.  The original seven components of the FAST HUG approach includes: F- Feeding; A- Analgesia.  Adequate pain relief is necessary, especially for procedures such as dressing changes.  S- Sedation, is the patient calm, comfortable and cooperative?    T-Thromboembolic prophylaxis; H- Head of Bed elevated, as wound care nurses, we advocate for the head of bed to be no higher than 30 degrees.  For mechanically ventilated patients, studies have shown a decrease in ventilator associated pneumonia rates if the head of bed is above 45 degrees.  U- Stress Ulcer Prevention and G-blood Glucose control.    FAST HUG rounds began in our critical care units in April 2011.  The skin team joined the rounds in May and quickly added the S for Skin.  Rounds take one minute or less per patient and at the conclusion of these rounds, we know:  who meets criteria for our sacral pressure ulcer prevention protocol, who has a prophylactic soft silicon foam sacral dressing in place, who needs a specialty mattress or static air cushion and who can have their specialty mattress discontinued.    We assess any patient with skin breakdown immediately after the conclusion of rounds and address staff teaching opportunities.  FAST HUGS is an excellent vehicle to hardwire skin assessment for the nursing staff.   FAST HUGS rounds have become a key driver of our critical care pressure ulcer prevention program enabling us to achieve excellent results.