Education Boosts Engagement and Reduces Pressure Injuries

Background

Hospital Acquired Pressure injury is a nurse sensitive indicator of quality care. In our 394- bed acute care, Magnet- accredited teaching hospital, pressure injury (PI) rates increased from fourth quarter 2016 to second quarter 2017. The increase followed an 11% vacancy rate that was filled by many new graduate nurses.  Orientation and continuing education material regarding PI prevention and wound identification lacked standardization. Wound champions were not clear on prevention interventions.  The WOC nurses and Staff Development Specialists (SDS) partnered to provide education to all nursing staff.

 Methods

Two web modules were developed to educate all clinical staff. The first illustrated how Braden sub-category scores drive a risk-specific prevention care plan. The second focused on wound identification and treatment. Hospital policies, evidence based practices and products were discussed in both. 

In January 2018, standardized wound education was added to the new graduate nursing Residency program. The education included a 60 minute prevention didactic; a 60 minute wound identification didactic, and a 30 minute case-study based simulation lab. In addition, Residents completed a four hour shadow experience with the Wound Care Team.

To improve Wound Champion participation, WOC nurses and SDSs engaged leadership to adjust staffing to allow Champions to attend monthly meetings. Champions were provided additional education on PI prevention and wound products. Wound Champions were coached on how to be leaders on their units to impact on clinical outcomes.

Outcomes

The Hospital Acquired Pressure Injury (HAPI) rate in fourth quarter 2017 was 4.57%.  After changes were implemented the HAPI rate decreased to 1.41% in the first quarter of 2018. In the second quarter of 2018, the rate decreased to 0.3% and  was maintained at 0.3% into third quarter of 2018.