Building Blocks for a Successful Pressure Ulcer Prevention Program

Program Description: In the early 2000s, our hospital committed to reducing the number of hospital acquired pressure ulcers.  Besides hiring a WOCN,  we created a system that combined assessment of risk with targeted interventions, staff education and the utilization of evidence based products to create increased patient satisfaction and good outcomes.  We initiated the Braden Pressure Ulcer Risk Assessment upon admission and every shift.    We purchased support surfaces that were rated for Pressure Ulcer prevention and treatment up to Stage IV Pressure Ulcers, and instituted evidenced based products for skin and wound care with education that emphasized preventative skin care, especially for incontinent patients.  We monitored our progress with quarterly, then monthly, Pressure Ulcer prevalence/incidence surveys, and participation in the Hill Rom International Pressure Ulcer Prevalence Survey.  We began a monthly educational program, “The Skin Is In”, to create Skin Champions on each unit with CNAs and  RNs who became experts in Pressure Ulcer prevention and treatment.  In 2010 hourly rounding started with the slogan, “Pain, Potty, Positioning” to help patients improve their mobility by having better pain control, continence management  and assisting them with positioning.

Results: St. Charles has consistently,(with a one exception), been below the National Benchmarks for HAPUs in both the acute and rehabilitation units

Conclusions: From 2010 until May 2012, the number of patients who would be expected, (statistically, based upon the benchmarks), to develop Pressure Ulcers was 134.  By  preventing those 134 HAPUs, we saved the cost of treating them, roughly $40,000.00 per patient, (CMS estimate for the care of 1 patient), which equaled $5,360,000.  Better outcomes for our patients and savings for our hospital, investing resources in Pressure Ulcer prevention is a “win/win” situation!