Abstract: Implementing an Initiative to Improve Knowledge and Practice in Pressure Ulcer Prevention in Two Intensive Care Units (2016 WOCN Society & CAET Joint Conference)

Elise Frans, MN, RN, CWON¹, Nicole Johnson, BSN, RN, CCRN², Janet Regan-Baggs, DNP, RN, ACNS-BC, CCNS, CCRN¹, Amy Haverland, MN, RN, CCRN², Courtney Crocker, BSN, RN, CCRN², Chloe Rahmun, BSN, RN, CCRN² and Lisa Wheeler, BSN, RN, CCRN³, (1)Patient Care Services, University of Washington Medical Center, Seattle, WA, (2)Medical-Surgical-Transplant ICU, University of Washington Medical Center, Seattle, WA, (3)Cardiothoracic ICU, University of Washington Medical Center, Seattle, WA

Purpose:To improve knowledge and pressure ulcer prevention practices of direct care nurses through an educational initiative in two intensive care units.

Background:During a quarterly pressure ulcer surveillance in 2014, the Cardiothoracic and Medical-Surgical-Transplant ICUs in an urban academic medical center had a unit-acquired pressure ulcer prevalence rate of 17.9%.

Description:Clinical Nurse Specialists (CNS), nurse managers, assistant nurse mangers, and two staff nurses from each ICU’s skin team designed an initiative which included weekly rounding and small group education with staff nurses. The two skin team nurses, managers, and assistant managers each received one hour of education from the Wound and Ostomy CNS to reinforce content and identify the best ways to deliver education. Over four weeks the team rounded in pairs on day and night shifts to educate staff nurses in groups of one to three.

Outcomes:Surveys measuring knowledge and self-reported practices were disseminated to all staff nurses before rounding and then one and four months after. In most instances, knowledge and self-reported practices increased at one month. At four months, knowledge and practices had declined slightly but were still higher than baseline results. Quarterly pressure ulcer prevalence data were evaluated before and after the intervention. Pressure ulcer prevalence rates decreased from 17.9% in quarter one of 2014 to 2.5% in quarter one of 2015.

Conclusions: There was no statistically significant improvement in knowledge or in self-reported practices pre and post intervention. Pressure ulcer prevalence had a strong decline over the course of the year following the intervention which may be attributed to the focus that this educational initiative directed at the problem. Ongoing collaboration of the skin care team with direct care nurses may have also contributed to the results.

PI16-028 Implementing an Initiative to Improve Knowledge and Practice in Pressure Ulcer Prevention in Two Intensive Care Units