Impact of the Wound Treatment Associate Program on Unit Acquired Pressure Injuries in the Medical ICU

The Wound Treatment Associate Program^® (WTA) is a continuing education program developed by the WOCN^® Society that prepares the staff nurse to serve as a unit based resource for nursing staff ¹. There is a strong focus on early intervention and prevention of hospital acquired pressure injuries (HAPI).

The WTA program was implemented in an urban academic facility with focus on the intensive care units. This hospital is a 900+ bed Magnet® designated facility with 125 critical care beds, including 24 Medical Intensive Care Unit (MICU) beds. Common diagnosis in this unit include: pneumonia, respiratory distress, sepsis, and renal failure. Despite interventions based on current standards of care,^2,3 such as high level support surfaces, heel offloading devices, and repositioning, HAPI’s persisted in the unit.

Three critical care RN’s completed the WTA program in November of 2016; they joined a fourth on the unit. These nurses are counted in regular staffing but are available to the other nurses as needed for assistance with wound assessment, verification of staging and early treatment recommendations. They perform monthly audits to ensure accuracy of reporting and documentation and provide unit based education on prevention protocols, pressure injury staging, and appropriate use of preventative and treatment products. The wound treatment associate educated RN’s work closely with the clinical nurse expert and the WOC nurse. This team has strong management support which includes time to work on education and best practice activities.

The results have shown a decrease in unit acquired HAPI’s for the beginning of 2017 as evidenced by the following NDNQI results:

3rd Quarter 2016    4th Quarter 2016          1st Quarter 2017         2nd Quarter 2017
11.11%                      5.0%                              00.00%                        00.00%

The WTA program has demonstrated that unit based resources contribute to HAPI reduction.