Team Approach to Inpatient Wound Care and Pressure Injury Prevention

Purpose
Decrease the amount of hospital acquired pressure injuries and incontinence associated skin damage, promote staff nurses to prevent wounds and initiate wound care upon admission.

Objective/Relevance/Significance
Foster independence with general nursing staff on medical surgical, orthopedics, telemetry, and ICU units to initiate wound care treatment and prevention plan upon admission prior to WOC nurse visit.

Strategy and Implementation
A wound resource team was created of ten nurse volunteers that work in the above units. Mandatory online CEUs and live hands-on classes with CEUs is completed each quarter. Topics of education included are pressure injuries and prevention, negative pressure wound therapy, continence, lower extremity wounds, and ostomy management. The nurses also participate quarterly in NDNQI pressure injury surveys, and their names are available the house supervisor for times of need.  Wound care resource manuals were created and are located in every clean utility room next to wound care and ostomy supplies. The manuals include algorithms of care for the above education topics, with color images, tabulated, with key for ease of use.  Incontinence barrier cream products were acquired in our supplies that had a color coding system to include zinc (orange), dimethicone (blue), antifungal (red).  Branding campaign was developed to market wound resource team, manuals, and stimulate prevention awareness. The campaign includes color coding of manuals and supply bins and slogan on the manuals and the T-Shirts/scrubs worn by the team.  House wide Lunch and learn on the pathophysiology of pressure injuries and MASD, the damaging effect of briefs and pull-up use in bedbound patients and alternatives to their use, how to implement pressure injury prevention based on low Braden Scores, how to implement the color coding of the new incontinence barrier creams, and how to document interventions completed into the EMR.