A Modeled Skin Integrity Program Solution " Consistently Meeting The Mark"

Purpose:
The intent of the program was designed to reduce the incidence of hospital acquired pressure ulcers below the national and facility benchmark of 8.6% while maintaining skin integrity in a safe manner.

Significance:
After reviewing past incidence data rates, processes, interventions and trends; administration along with the nursing team and existing wound team agreed on the necessity to develop a clear and concise process for pressure ulcer identification, prevention and management.

Strategy and Implementation:
4-month initiative under facilitation of the CWOCN and Unit Based Leadership Teams. Teams consisted of a unit manager, education specialist, clinical leaders, care coordinators and wound team representatives.During this time, the hospital underwent a product formulary change of wound care products,diapers and bed upgrades. P.U.P.P consists of (3) phases. 1. Mandatory pressure ulcer prevention training for all direct care nursing providers with successful completion of pre-and post testing. 2. Bedside validation of nursing performance of all interventions and process indicators. During this phase, in-house monthly pressure ulcer prevalence/incidence surveys were conducted using the NDNQI format over the latter three month period of the program. In addition, in servicing of current wound care and pressure ulcer prevention products were provided by partnering vendors. 3. Staff recognition for successful program completion and incorporation of principles into current practice.

Evaluation:
Data comparison of incidence rates prior to/after P.U.P.P implementation utilizing mock surveys/quarterly NDNQI PU surveys. HAPU incidence has decreased from 14% in 2008 to current 4% ending 2009 January,2010-HAPU rate 3.9% February,2010-HAPU rate 2.3% March,2010-HAPU rate 2.5%

Implications for Practice:
Results,improved patient outcomes heightened quality care in pressure ulcer prevention and management has helped to ensure a consistent modeled solution to the reduction of nosocomial pressure ulcer incidence rate, overall organization cost savings and customer satisfaction.