Strategies for Design and Implementation of a Skin Health Program in an Acute Care Peidatric Facility

Purpose

Pressure ulcers contribute to poor clinical outcomes increased length of stay for pediatric patients. Risk assessment, early prevention, and evidence based treatment are critical elements of care for skin maintenance in hospitalized pediatric patients.

 

Best Practice Standards

Historically, pediatric skin care has been based on evidence used in Adult Care practices. There is limited clinical research on the pediatric population and pressure ulcer formation. Quigley & Curley (1996) adapted the Adult Braden Scale for Predicting Pressure Ulcer Risk for use in the pediatric population naming it the Braden Q Scale.

 

Implementation Strategy

Development of a hospital wide approach to evidence based risk assessment, prevention, and early intervention has resulted in positive patient outcomes. Continuous building of a team of RN Skin Champions through education and training in NDNQI prevalence data collection provides resource nurses on units for excellence in skin care. Training and education of bedside nurses vis RN Skin Champions, has heightened awareness of the significance of skin health maintenance.  Implementation of Electronic triggers for individualized prevention plans of care, implemented based on the Braden Q risk subscale score, ensures early intervention practices.

 

Evaluation: Data outcomes from the Hill-Rom International Pressure Ulcer Prevalence Survey illustrates in a steady decline in Hospital Acquired Pressure Ulcers over a 3 year period.

 

Implication for Practice: Team building, bedside nursing education, collaboration among disciplines within the facility, utilizing evidence based best practice as well as networking with external experts, has a positive impact on patient outcomes