Establishment of a Hospital-Wide Pressure Ulcer Prevention Program

Hospital-acquired pressure ulcers are both painful and costly.  However, pressure ulcers can be prevented.  This article describes the impact of establishing a hospital wide pressure ulcer prevention program, lead by Wound Ostomy Continence nurses, in a 400-bed, acute care, not-for-profit facility.  Success of the program has demonstrated a hospital wide decrease in pressure ulcer incidence from a rate of 1.35 pressure ulcers per 1000 patient days in 2009 to a rate of 0.66 in 2011, a 52% decrease overall.  Key components contributing to success of the pressure ulcer prevention program include: Wound Ostomy Continence (WOC) nursing department, detailed pressure ulcer tracking system, pressure ulcer prevention committee, skin champions, new products, and device-related pressure ulcer prevention initiatives.  Collection of accurate, detailed data through standardized tracking of all pressure ulcers and a retrospective audit of all previous preventive interventions was pivotal to establish current problems and needed improvements.   Extensive, empirical-based, best-practice toolkits for pressure ulcer prevention are available to assist with incidence reduction initiatives.  However, “one-size-fits-all” approaches are impractical; an individualized plan needs to be integrated.  Problem-solving approaches such as root cause analyses and quality improvement workshops were utilized to develop this unique plan, and these methods were pivotal to this hospital’s success.