Got Safe Skin? Decreasing Pressure Ulcer Prevalence

Purpose:
The Got Safe Skin program was launched when prevalence studies indicating a higher then average pressure ulcer prevalence when benchmarked against other NDNQI hospitals of similar size. The goal of the strategy was to reduce the pressure ulcer prevalence rate by 2.5 percent per year.

Significance:
In the fall of 2008, CMS guidelines regarding hospital acquired conditions were initiated. Pressure ulcers impact the financial, quality, and customer service quadrants of the hospitals balance score card and cause pain and suffering to patients.

Strategy and Implementation:
Minnesota Hospital Association granted the hospital permission to use evidence-based Safe Skin program as an implementation plan to prevent pressure ulcers. S: Skin Safety Coordination: Six hour class to develop champions A: Accurate Concurrent Reporting: SKIN bundle, Quarterly prevalence, coded data, utilize shared governance model. F: Facility Expectations,Staff Education, Accountability: Associates assigned NDNQI tutorial E: Education for Patients and Families: Materials developed and accessible through computer system S: Skin Inspection and Risk Assessment: Assessment education and Braden scale documentation, NDNQI tutorial,automated reports generating consults for high risk patients K: Keep Pressure Off: Minimize Pressure, Friction,and Shear:Surface education, bed school, pre-printed specialty bed orders, safe patient handling equipment, paging staff for turning q2h I: Incontinence/Moisture Protection: Skin care protocol and algorithm N: Nutrition: Education

Evaluation:
Successful reduction of hospital acquired pressure ulcer excluding stage I was measured using information from prevalence reports. The baseline prevalence before the intervention was 10.7%. After one year the prevalence was 2.5% an 8.2% reduction in pressure ulcers was achieved.

Implications for Practice:
Implementation of skin care team champions produced a reduction in the number of hospital acquired pressure ulcers greater then stages I. Due to this success the initiative will be implemented on the remaining 13 impatient units. Monthly skin team champion meetings will be expanded.