The NEXT GENERATION of Pressure Ulcer Prevention: (APPLES) Aligning Partners Practice & Leadership to Elevate Skin

Operational reform, streamlining, and cultural shift within our hospital system mandated a comprehensive review of our pressure ulcer prevention program (PUPP).  The existing program lacked cohesion and revealed deficiencies in process and structure within the re-defined system as reflected through outcomes.  Evaluation created a sense of urgency that required innovative restructuring, the addition of value-added elements, and ALIGNMENT of key components.   Outcomes and non-compliance with updated PRACTICE guidelines identified the need for the NEXT GENERATION PUPP known as APPLES: Aligning Partners Practice & Leadership to Elevate Skin.

Objectives:

• ALIGN LEADERSHIP with internal and external PARTNERS who bring expertise in compliance, health economics, and PRACTICE guidelines with unbiased evaluation and outcomes reporting
• ELEVATE existing Skin Champions to the role of expert PUPP PARTNERS as an extension of the WOC nurse
• Promote the role of Hospitalists and PATIENTS as PARTNERS through collaboration and PRACTICE
• Optimize the EMR as a source of education that provides direction for implementation and documentation supported by updated Clinical PRACTICE Guidelines
• Maximize the EMR capability to provide one-touch reporting by extracting and exporting data for compliance review, e-measures, and program evaluation

Outcomes:

• LEADERSHIP as PARTNERS can review and respond to real meaningful data related to outcomes, costs, and program expansion
• The EMR and educational applications using finger-tip technology have produced an increase in PARTNER participation and knowledge
• “TOP 100” recognizes nurse experts as PUPP PARTNERS in PU identification, staging, prevention and education
• Visual cues have enabled at risk patients to be identified on and off the unit to ensure 24/7 prevention
• Ongoing EMR optimization has ALIGNED PRACTICE and documentation with evidence based guidelines
• The NEXT GENERATION PUPP is positioned for implementation as a program to optimize daily practice, allow continuous systematic review to cost effectively improve quality and outcomes and to provide ongoing evaluation for sustainability and change