Introduction of a Pressure Injury Dedicated Nurse to Reduce Hospital Acquired Pressure Injury Rates at an Academic Medical Center in the Southeastern United States

Valerie Kneece, BSN, RN, CWCN, Wound Care Nursing, Quality and Patient Safety, Medical University of South Carolina, Charleston, SC, Phill Botham, BSN, RN, ET, CWON, Wound Care, Medical University of South Carolina, Charleston, SC and Danielle Scheurer, MD, MSCR, SFHM, Quality and Patient Safety, Medical University of South Carolina, Charleston, SC
INTRODUCTION: At an academic medical center in the Southeast, hospital acquired pressure injury (HAPI) rates had fallen since the introduction of an education bundle in 2013. However, these numbers were still above the national average of 2.5% per the National Database of Nursing Quality Indicators (NDNQI) guidelines. A joint decision between the WOC Lead Coordinator and the Director of Quality & Patient Safety lead to the development of a Pressure Injury Prevention dedicated nurse. The Pressure Injury Preventionist (PIP) is a wound care certified nurse whose primary roles are prevention education, chart auditing, and coordinator for the hospital wide Skin Survey Team.

METHODS: The PIP began seeing all pressure injury patients to increase floor staff’s familiarity with the role and assess their education needs. Chart audits were performed and sent to nurse managers for review. The PIP took an active role during NDNQI Skin Survey Days, performing random checks and being available to surveyors.

RESULTS: The NDNQI Skin Survey determines the prevalence rate of HAPIs on a quarterly basis. HAPI rates were 3.4% in December 2015 and 2.7% in March 2016. After hire and training of the Pressure Injury Preventionist (PIP) in March 2016, survey numbers for June 2016 were 2.14% and 1.84% for September 2016.

CONCLUSIONS: A dedicated WOC nurse that focuses on Pressure Injury Prevention alleviates the burden of prevention education on the entire WOC team. The PIP is an effective liaison between hospital administration and floor staff. With the PIP and Lead WOC Coordinator, a Pressure Injury Prevention Education Bundle is planned for January 2017 to review the updated NPUAP staging guidelines and a Pressure Injury Standing Order Set. The order set gives floor nurses some autonomy in their practice and improves patient outcomes by providing dressing guidelines for night shift and weekend nurses.