Unit based Skin Care Champions - Achieving and Sustaining reduction in Pressure Ulcers

Purpose:
Incorporating pressure ulcer prevention into nursing practice in the acute care setting can be challenging. The goal of the unit-based skin care champion model is to educate and empower the local nurse to impact practice within her work unit via education and data sharing.

Significance:
Preventing pressure ulcers in the acute care setting has become a national focus. The national incidence of hospital related pressure ulcers has not been significantly reduced over the past several years. The unit-based Skin Care Champion model can provide both positive and sustainable results.

Strategy and Implementation:
There are several components to a successful pressure ulcer prevention protocol. In 2001, Duke Hospital lauched a Unit-based Skin Care Champion program as an integral part of a pressure ulcer prevention plan. The Unit-based Skin Care Champion role was developed by a multidisplinary team. Registered Nurses and Nursing Assistants were solicited from each inpatient unit, specially trained and empowered to educate their staff and monitor unit specific acquired pressure ulcers. A Wound Management expert is assigned to each unit for the purpose of mentoring and facilitation unit education. Program implementation included; an initial eight hour educational workshop, monthly data collection performed by the Unit-based Skin Care Champion, online educational modules serve as part of orientation to role, real time communication to each unit's clinical team for all nosocomial pressure ulcers and ongoing quarterly and annual educational workshops.

Evaluation:
The Unit-based Skin Care Champion program has been key in decreasing Duke Hospital's facility acquired pressure ulcer rate from a high of 6.8% prior to the lauch of the program to the most recent rate of 1.90%.

Implications for Practice:
Significant sustained reduction in hospital acquired pressure ulcers can be achieved in the acute care setting through implementation of a pressure ulcer prevention program. Ongoing educational support, regular feedback of data, and access to clinical experts are all vital to the success.