Implementation of a Pressure Ulcer Prevention Program (PUPP) at two Urban Hospitals

Implementation of a Pressure Ulcer Prevention Program (PUPP) at two Urban Hospitals

PURPOSE:  To describe the motivating factors behind the implementation of a PUPP at 2 urban hospitals along with the execution process and effects of the PUPP implemented in those hospitals.  BACKGROUND:Pressure ulcers are an important quality of care indicator for patients, 3rd party payers, and regulators because they are largely preventable. PrUs are a significant source of morbidity with 3.5 cases of PrU associated sepsis for every 10,000 hospital discharges. PrUs are a significant cause of mortality, causing 60,000 deaths due to related complications yearly. The cost of PrU related care ranges from $500 to $130,000 per ulcer.  METHODS:Measurement through Baseline prevalence data collected at both hospitals.  Goal: Reaching the national benchmark or being below the benchmark in 4 months.  Planning:Working with hospital administration to get support and resources. Identification of key steps for Pressure Ulcer Prevention: Reassess Risk for all patients daily, Inspect skin of at Risk patients daily. Manage Moisture, Optimize Nutrition/Hydration and minimize pressure. Consultation for nourishing and protective skin care products, use of dry air flow pads.  Implementation through education with mandatory requirement for all nursing staff to complete a Pressure Ulcer Prevention Program, including measurement and documentation of wounds, wound management, and prevention.  The WOCN would give a one-hour lecture to all new Nurse Orientees.  ASkin and Wound Quick Reference Guide was developed. Evaluation of the effects of implementing our PUPP was measured by collection of data through The PrU study done at both hospitals. Results: For both hospitals combined there was a significant drop in PrU prevalence when comparing pre PUPP (30.15%) to post PUPP (0.85%) (x2=36.57, N=254, p<0.0001.  Conclusion:  Overall our hospitals were able to reduce the PrU prevalence to levels below the NDNQI benchmark standard of 9.6%; this reduction was significant.