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1573 Initiative to Improve Communication Among Nurses and Nurse Assistants utilizing the Braden Risk score

Nancy S. Walsh, BS, RN, CWOCN, Western Ct HealthNetwork, Manager of Nursing Quality Initiatives, Danbury, CT, Layla Nejati, BSN, RN, WOCN, Western Ct Health Network, Wound ostomy nurse co-ordinator, Danbury, CT, Alyson Blanck, MSN, RN, Western Ct health Network, Director of Nursing Practice, Danbury, CT and Ann Marie Lavery, RN, MHA, Western Ct Health Network, Director of Patient Care Services, Danbury, CT
Pressure ulcer prevention at our regional medical center included the Braden Risk Scale1 “Six Essential Elements of Pressure Ulcer Prevention” (IHI)2 , Wound, Ostomy Continence Nurse Society(WOCN) 2003 clinical practice guidelines3; the National Pressure Ulcer Advisory panel /European Pressure Ulcer Advisory panel (NPUAP/EPUAP) Prevention and Treatment guidelines4; in 2010,  the use of a soft silicone sacral dressing5.

In 2012, we still were struggling with pressure ulcer numbers. We began an initiative to improve communication among nurses and nursing assistants utilizing the Braden Risk Scale.

We chose a 26 bed medical surgical unit as the pilot. The staff selected a Huddle format.

The purpose of the huddle is to proactively prevent skin issues for the at risk patients. The sharing of the plan of care among nurses and nursing assistants’ will provide for continuity of care especially proactive not reactive care with the following plan:

The RN’s are responsible to report to the nursing assistants /RN’s

  1. The Braden Score of the patient
  2. The mobility/activity level of the patient
  3. The moisture/incontinent status of the patient
  4. Write the patient’s score(18or less) on the white board in the nurses’ station

 The nursing assistants’ are responsible to report during shift hand-off:

  1. The last time the patient was turned and positioned
  2. The last time incontinent care was done
  3. The moisture /incontinence status of the patient.
  4. The Braden Score of the patient(18 or less)
  5. Write the patient’s Braden Score on the: the white board in the patient’s rooms/nurses  station

The Braden Score in the patient room should be circled when a wound is present.

This initiative was begun in March 2012. In August the incidence was zero for that unit. The overall hospital incidence was below 2% for 2012 since we began tracking 2007.

 


 

 

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