Twilight (The Flamingo Hotel)
Monday, 29 January 2007
6:30 PM - 8:00 PM
Twilight (The Flamingo Hotel)
Tuesday, 30 January 2007
4:30 PM - 6:00 PM

Measurement Monday: Standardization in Pressure Ulcer Management

Arlene Lantz, RN, MS, BC, CNA1, Kelli O'Harrow, RN-, BC2, and Dawn Rishel, BSN, CCRN2. (1) Clinical Outcomes, Robert Packer Hosptial, 1 Guthrie Square, Sayre, PA 18840, (2) Nursing, Robert Packer Hosptial, 1 Guthrie Square, Sayre, PA 18840

Early recognition of skin breakdown is important to patient care.  Preventing pressure ulcers and maintaining skin integrity are vital nursing concerns.  When pressure ulcers are present, consistent documentation of their measurement and description becomes critical.  A 238- bed tertiary care teaching hospital in the Northern Tier of Pennsylvania identified that pressure ulcers were not documented consistently.  Nursing staff struggled to remember when pressure ulcer measurements were to be performed and found that NDNQI pressure ulcer data fluctuated as compared to the mean.  In an attempt to standardize this practice throughout the facility and maintain NDNQI pressure ulcer data below the mean, a Performance Improvement (PI) initiative, Measurement Monday, was developed to address these concern. 

This presentation has two main objectives.  First, the participant will describe how Measurement Monday is implemented on nursing units.  Second, the participant will discuss how the Nursing Clinical Outcomes and Research (NCO&R) Council utilizes the NDNQI data to evaluate this PI initiative.

Pressure ulcer prevention and management is a complex issue which can lead to expensive patient care problems and extended length of stay.  This initiative is relevant to nursing practice because consistent documentation improves outcomes by tracking pressure ulcer healing and allowing for better evaluation of treatment effectiveness.   The information is current, as Measurement Monday is evaluated regularly by the NCO&R Council, utilizing quarterly NDNQI data for hospital acquired pressure ulcers, in addition to monthly pressure ulcer rates as provided by the facility’s Wound Care & Ostomy nurse.

This presentation will include Measurement Monday documents, general program information, staff education materials, ruler symbols used to identify patients with pressure ulcers and a summary of how this program has progressed since initiation.  In addition, both NDNQI quarterly graphs and monthly internal data graphs utilized by the NCO&R council depicting pressure ulcer data before and after the implementation of this program will be displayed.  For example, the NDNQI data supports that over the past two quarters since Measurement Monday has begun, the facility mean for hospital acquired pressure ulcers has dropped from 9.11% to 3.63%, which is well below the NDNQI mean of 5.15% for bedsize 100-199.

This presentation will provide practical and easy to use information for nurses in any acute care nursing practice. Standardization of this process will support nursing practice by providing a tool for documentation of ulcer size and description and a serve as a reminder for a consistent means of ulcer measurement.   A program such as Measurement Monday will not only improve patient outcomes, but ensures that, regardless of patient location or care provider, pressure ulcer care and assessment remains consistent. 


See more of Using Quality Indicators to Achieve Quality Improvement
See more of The NDNQI Data Use Conference (January 29-31, 2007)