Do patients in a tertiary surgical intensive care unit, when turning wedges and turning signs are implemented, have a decreased rate of sacrococcygeal pressure ulcers?

Do patients in a tertiary surgical intensive care unit, when turning wedges and turning signs are implemented, have a decreased rate of sacrococcygeal pressure ulcers?

Purpose:  To reduce the number of patients acquiring sacrococcygeal pressure ulcers in the surgical intensive care unit.

Description:  A reduction in the incidence of Hospital Acquired Pressure Ulcers (HAPUs) remains a high priority in today’s health care.  A review of six months of skin prevalence data indicates the need for a more focused approach toward reducing the incidence of HAPUs in the surgical intensive care unit (SICU).   In response to this problem an action plan to prevent and combat pressure ulcers was developed.  In addition to our existing pressure ulcer prevention plan twelve turning wedges (one for each SICU room) were purchased.  Turning right and left only (no back) wedge signs were developed and placed on patient’s doors if their Braden Score was 18 or less, or mobility subscale was 3 or less, to remind the lift team and the nurse this patient needed to be turned every two hours.   Staff education encompassed the proper use of the turning wedge and placing the turning sign on the patient's door when appropriate. The six month pilot study took place from April 1^st to October 1^st 2014.   In addition to staff education and our monthly mandatory skin prevalence, an additional day every month was dedicated to skin prevalence in the SICU.  This data was summarized to highlight findings related to the use of the turning wedge, turning patient right and left only, and placing the turning sign on the patient's door.  Staff nurses were kept informed of the skin prevalence results that were performed twice a month and encouraged to take accountability for patient care and use this information to improve patient outcomes.