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Topic:
Hospital-acquired pressure injuries (HAPIs) are costly, often preventable, and can negatively affect an organization’s reputation and finances. The unreimbursed cost of a stage 3 or stage 4 HAPI can range from $5000 to $151,700. A growing body of evidence suggests that improved patient outcomes can be achieved through nurse-led interdisciplinary approaches to pressure injury prevention (PIP). Seldom are WOC nurses leading this charge.
Purpose:
In 2018, a 495-bed acute care facility in the Northeast United States experienced an unfavorable trend in HAPIs, signaling the need for immediate process improvement. The purpose of this practice innovation was to demonstrate the effectiveness of the WOC nurse as a transformational leader through the development and implementation of an organizational PIP strategy grounded in a culture of excellence, improved quality, and reduced health costs.
Objective:
The WOC nurse emerged as a transformational leader by engaging more than twenty-one key stakeholders to evaluate current evidence, identify best practices, and establish evidence-based guidelines grounded in Lean methodology. A number of innovative strategies were employed to standardize and streamline care, including unit-based wound carts organized in alignment with expected workflow, routine compliance rounds, customized multi-media health professional education, evidence-driven product selection and SKU management; in addition to modification of the electronic health record to reflect expected practice to improve the accuracy of documentation. HAPI incidence and cost outcomes were measured pre- and post-implementation.
Outcomes:
In 2018, HAPIs were reduced from 19 in February to 7 in September, representing $438,000 in treatment cost avoided and 84 hospital-days avoided. This denotes a return on investment of 132.83% (ROI) in 0.34 years. If costs saved remain on the same trajectory, a 1,100.96% annualized ROI can be expected. Qualitative outcomes included SKU consolidation, improved compliance to the established practice, and nursing time saved.
Hospital-acquired pressure injuries (HAPIs) are costly, often preventable, and can negatively affect an organization’s reputation and finances. The unreimbursed cost of a stage 3 or stage 4 HAPI can range from $5000 to $151,700. A growing body of evidence suggests that improved patient outcomes can be achieved through nurse-led interdisciplinary approaches to pressure injury prevention (PIP). Seldom are WOC nurses leading this charge.
Purpose:
In 2018, a 495-bed acute care facility in the Northeast United States experienced an unfavorable trend in HAPIs, signaling the need for immediate process improvement. The purpose of this practice innovation was to demonstrate the effectiveness of the WOC nurse as a transformational leader through the development and implementation of an organizational PIP strategy grounded in a culture of excellence, improved quality, and reduced health costs.
Objective:
The WOC nurse emerged as a transformational leader by engaging more than twenty-one key stakeholders to evaluate current evidence, identify best practices, and establish evidence-based guidelines grounded in Lean methodology. A number of innovative strategies were employed to standardize and streamline care, including unit-based wound carts organized in alignment with expected workflow, routine compliance rounds, customized multi-media health professional education, evidence-driven product selection and SKU management; in addition to modification of the electronic health record to reflect expected practice to improve the accuracy of documentation. HAPI incidence and cost outcomes were measured pre- and post-implementation.
Outcomes:
In 2018, HAPIs were reduced from 19 in February to 7 in September, representing $438,000 in treatment cost avoided and 84 hospital-days avoided. This denotes a return on investment of 132.83% (ROI) in 0.34 years. If costs saved remain on the same trajectory, a 1,100.96% annualized ROI can be expected. Qualitative outcomes included SKU consolidation, improved compliance to the established practice, and nursing time saved.