![[ Visit WOCN Website ]](images/banner.jpg)
Hospital Acquired Pressure Ulcers (HAPU) are considered preventable in almost every case. Pressure ulcers not only negatively impact a patient's quality of life, they cause significant financial burden to a hospital. Since 2012, the incidence of HAPU at this facility has been consistently above the national average. The purpose of this quality improvement initiative was to implement evidence-based practices to decrease the incidence of HAPU in our hospital.
Methods
The U. S. Department of Health & Human Services, Health Research & Educational Trust (2012) "Implementation Guide to Prevention of HAPU" provided a framework for this project. A gap analysis revealed evidence-based practice and process change opportunities.
The existing Skin Care Committee was charged to lead the process improvement initiative. The committee was restructured to include staff and clinicians from all clinical nursing areas, information systems, housekeeping and linen, physical therapy, risk and safety management, respiratory therapy, materials management and nutrition services. This multidisciplinary team collaborated to identify key strategies for successful implementation.
Multiple venues were utilized to educate staff on the evidence-based changes. The wound nurses provided "Skin Squad" roving education to nursing and ancillary support departments. This education was reinforced by computer based training, annual skills day training, and individual training by unit managers.
Results
Prior to implementation of the evidence based changes, our hospital's HAPU rate failed to meet the desired target. The application of the evidence-based practice and process changes resulted in a 59% reduction of our HAPU rate from January through August 2014.
Conclusion
Leader support and staff involvement, along with the initial and ongoing staff education is imperative to achieve and maintain best practice results. The patients at this facility benefit daily from the work and results produced by this quality improvement project, which started with a review of the literature that nursing research provides.