Abstract

ANA Call for Abstracts

National Data Use Conference

January 30-31, 2007

Las Vegas, Nevada

As a modification of the Iowa Model for evidence-based practice, this prospective evidence based practice project will evaluate the outcomes of a bedside pressure ulcer screening tool.  Supported by NDNQI data on pressure ulcers, the intent was to develop a well-performing, brief, user-friendly, bedside pressure ulcer screening tool for staff nurses to use for adult patients admitted to the acute care hospital. The prior screen had a low positive predictive value (14%) resulting in unnecessary use of resources, i.e. skin assessments by the WOCN RN Team. Review of current evidence resulted in the development of a screen with four (4) weighted criteria which was piloted by the WOCN Team (n = 144) and found to be statistically significantly associated with hospital-acquired pressure ulcers (HAPU). The association had only slightly less magnitude than the Braden Scale in side-by-side comparison. Staff nurses in this hospital find the Braden scale somewhat cumbersome and less sensitive in the busy acute care setting. Subsequent to the pilot study and after multiple reviews by related nursing committees in-house, the new screen was accepted for further evaluation and imbedded into the daily patient assessment flow sheet. After 3 months, patient and process outcomes will be evaluated and analyzed across the hospital nursing practice.  A stratified random sample of at least 150 patients will be collected over a period of 3 months. Screening, and outcome data from NDNQI, will be analyzed at the patient level, focusing on single indicator and aggregate scores.  Outcomes including identified risk, interventions, and HAPUs will be evaluated from structure, process and outcome perspectives supported by local NDNQI data.