Improving Outcomes by Reducing Pressure Ulcers: A Data Driven Prevalence and Incidence Program

The clinical, economic, and quality-of-life consequences of pressure ulcer development are monumental. Pressure ulcers are associated with an increased mortality rate evidenced by data suggesting that approximately 1 in 25 admissions to acute care settings related to pressure ulcers results in death.  New federal legislation has increased hospital accountability for pressure ulcer incidence and imposes financial consequences for failure to improve the incidence of  nosocomial pressure ulcers. This poster describes a Prevalence and Incidence Program designed for a 205 bed, urban, community hospital. Collected data informs continuous quality improvement (CQI) initiatives. Prior to the implementation of this program, the hospital surveyed pressure ulcer incidence by using an annual industry-sponsored prevalence study. Wound care services were addressed without the expertise of a full-time Certified Wound Care Nurse (CWCN).  Quarterly Prevalence and Incidence (P & I) studies are necessary to satisfy National Database of Nursing Quality Indicators (NDNQI) compliance requirements. This program was developed by an Advanced Practice Certified Wound Care Nurse (CWCN).  The Nurse Practitioner instituted quarterly P & I studies and constructed a unique tool for data collection. The tool facilitated the identification of specific deficiencies on each nursing unit that correlated with wound prevention or treatment interventions. This strategy enhanced data analysis and enabled the Advanced Practice CWCN to order specific interventions to improve patient outcomes. Finally, a process for second tier data analysis enabled the CWCN to create an Executive Report for Hospital Administration.  This report is designed to augment raw P & I data to satisfy NDNQI requirements while also enabling clinicians to directly influence CQI results by designing data-driven, targeted interventions.  The data collection process has improved CQI efforts and has the potential to influence outcomes within the facility’s larger heath system following large-scale implementation.