Skin Integrity and Pressure Injury Prevention: Development and Implementation of a Skin/Wound Resource RN program (SWRRN)

This Metropolitan, 400+ bed Level I trauma center is designating financial resources and staffing toward hospital acquired pressure injury reduction and prevention. CWOCNs with the Department of Practice, Education, & Research, use an evidence-based practice approach with the goal to develop unit-based Skin/Wound Resource Nurses (SWRRNs). These specially trained nurses are utilized as a conduit to promote skin integrity and implement changes hospital wide.

     Project proposal included: committee planning, curriculum development, classroom space, funding sources, marketing, vendor fair and supplies. Curriculum content was crucial. First, properties of the skin, how it can be influenced by intrinsic and extrinsic factors and why it fails is emphasized. Next, a multidisciplinary team including Respiratory, Clinical Nutrition, Physical Therapy and Vendors discuss their services impact on care. Finally, roles and expectations of SWRRNs are reviewed. The curriculum is formatted digitally. Participants bring their personal electronic device to class.

     Attendants complete the National Database of Nursing Quality Indicators  (NDNQI) modules in addition to other course pre-work. Using information from published sources each cohort is provided with the tools to have a “more than basic” understanding of skin and its function. The goal of the eight-hour experience is to build the foundation of enhanced critical thinking around prevention and treatment.

     Selection of a SWRRN cohort is completed by a multi-disciplinary team. The selection committee decides strategically to cover many units and shifts. A total of 120 RNs completed the course since October 2015 and the program has lost only 10 participants in two years. SWRRNS make significant impacts in pressure injury prevention. The hospital, in previous three years reported 52 hospital acquired pressure injuries with 13 in 2015. 2016, report indicated 10, demonstrating a decrease from the previous year. Administration endorses, that the SWRRNs, are functioning on their units, improving patient care and positively affecting outcomes.