Implementation of The Wound Treatment Associate Program in the ICU to Reduce the Incidence of Pressure Ulcers

In 2012, an analysis by the Patient Safety Committee of hospital acquired events, insurance carrier actuarial data, and Patient Safety Organization benchmarking studies revealed an increase in number and severity of Pressure Ulcers (PU), inconsistent staging, documentation, and poor skin assessment in two critical care areas. The primary aim of this research study was to evaluate the impact providing nurses advanced training on the prevention of PU’s would have on early recognition and treatment of pressure ulcers. Another aim of the study was to evaluate whether daily skin assessments performed by specially trained nurses would result in a decreased occurrence of avoidable PU's. Eight critical care nurses received training by attending the Wound Treatment Associate program (WTA) for three months. The program is endorsed by the Wound Ostomy Continence Nurses Society. The WTA program enabled nurses to assist with daily patient monitoring, pressure ulcer prevention, and basic wound management under the direction of a certified wound care nurse. The WTA's performed skin assessments every 24 hours for three months on all eligible patients in the two critical care units. The WTA's identified skin breakdown and noted these findings on a bedside tracking tool indicating the stage of the pressure ulcer. in which a consult was placed to the wound care team. At the conclusion of the research project, daily skin assessments resulted in early recognition, documentation and treatment of skin breakdown.This in turn led to the resolution of suspected deep tissue injury and stage 1 ulcers preventing advancement to a higher stage and developing an early treatment plan for those pressure ulcers stage 2 or higher which also resulted in increased healing. PU's identified during the research project led to resolution of Suspected Deep Tissue Injuries, Stage 1- 32% healed, Stage 2 – 33% healed, Stage 3 – 11% healed,  Suspected Deep Tissue Injury - 21% healed, Unstageable - 18% healed,  Moisture Lesions - 15 % healed.