Interdisciplinary collaboration in preventing pressure ulcers

Background.  Our 338-bed acute-care facility has a group of skin champions, mostly RNs, who represent their units in monthly skin champion meetings and quarterly pressure ulcer prevalence surveys. However, despite the involvement of the RNs and the Wound, Ostomy and Continence (WOC) nurses through our Skin Champion program, our hospital acquired pressure ulcer (HAPU) rates did not decline in 2013.  Methods. The WOC nurses and their manager engaged the other departments and employees in our pressure ulcer prevention initiatives: 1) The CNAs were invited to join the skin champion meetings.  Newly hired CNAs also orient for four hours with the WOC nurses reviewing pressure ulcer prevention measures.  2) Materials Management worked with the clinical managers to procure new specialty mattresses, making them easily accessible to the staff.  This also helped reduce our rental costs.  Materials Management also facilitated the introduction of skin barrier wipes and a turning system—both items new in our formulary.  3)  Respiratory therapists collaborated with the ICU staff to help decrease HAPUs from tracheal tubes and oxygen masks.  4) All patients with pressure ulcers were referred to the dietitians.  5) Physical therapists assisted with the development of safe ambulation and mobilization practices of patients.  6) Physicians are notified of all pressure ulcers upon discovery.  7) Patient and family participation is promoted.  8) Management supported pressure ulcer prevention initiatives.  Results.  In 2013, there were 183 HAPUs reported in our facility.  From January to August 2013, there were 127 HAPUs.  In the same time frame in 2014, there are only 47 HAPUs, which represents a 68 % decline.