Use of Weekly Skin Rounds To Improve Nursing Staff's Knowledge Of Best Practices For Pressure Ulcer Prevention

BACKGROUND:  Telemetry unit asked WOCN to help lower unit's high quarterly prevalence study rates. PURPOSE:  A project was initiated to perform weekly skin rounds. The idea was that skin rounds provided a "in the moment" opportunity for identification of skin issues and pressure ulcer prevention and treatment. This would increase staff's knowledge. Staff would then implement interventions on own to provide best practices for pressure ulcer prevention. The result would be a decrease in hospital acquired pressure ulcers evident during prevalence studies. METHOD:  The WOCN with the help of the unit's Wound, Ostomy, Continence Associate Nurse, performed weekly skin rounds. Each Wednesday the daily census was examined. Patients who had a Braden Score of 18 or less were considered at risk and they would have a head to toe skin assessment performed. The skin team would implement what interventions were needed and then inform the accountable nurse and nurse aide for that patient. It became evident that 3 areas needed improvement: moisture management ( use of appropriate incontinence products or within skin folds), floating heels off the bed, and use of oxygen protectors. As a way to track if skin rounds were making a difference, WOCN gathered data on these 3 areas. The data compared the number of times the nursing staff did the appropriate intervention and when the skin team performed it. OUTCOMES:  Graphs display the results. Moisture management reflected an increase in staff's interventions. The other 2 areas did not. This information has helped the facility restructure their pressure ulcer prevention education program. NEXT STEP: Maintaining awareness to pressure ulcer prevention remains a priority. Weekly skin rounds are going to be continued. The project has begun on a similar Telemetry unit and results will be compared.