The Design and implementation of a wound care resource nurse group

Purpose:
To organize a group of staff registered nurses with the desire to increase the knowledge of pressure ulcer risk, prevention, staging and treatment. Through mentorship, nurses could improve patient outcomes related to prevalence, incidence and treatment of pressure ulcers.

Significance:
Each year nearly one million people develop pressure ulcers; resulting healthcare costs exceed $1.3 billion (Institute of Healthcare Improvement). The nurse's assessment of pressure ulcer risk, prevention and staging on admission is critical, as hospital acquired pressure ulcers are not reimbursed.

Strategy and Implementation:
The first step was to identify a group of staff RNs who have a desire to increase their knowledge in pressure ulcer prevention, staging and treatment. The Nurse Clinician for wound care was able to recruit staff nurses who expressed an interest and formally established a monthly meeting time. Managers were informed and their cooperation in enabling the RNs to attend meetings was crucial to success. They were required to perform the NDNQI online Pressure Ulcer Training module, as well as, demonstrate competency in prevention strategies, staging, treatment and documentation. The Nurse Clinician worked one on one at the bedside with these nurses to teach, nurture and assess their competencies. One of the successful strategies to increase membership is to encourage the Wound Care RN to bring a ‘guest' RN to a monthly meeting. Nursing leadership support for RNs was key for this initiative. Time to attend meetings, in-services and conduct prevalence studies is essential for success.

Evaluation:
The NDNQI online Pressure Ulcer Training module was so positively received it was suggested all RNs complete the module. Best practices to improve patient outcomes related to prevalence were evidenced by three out of seven units at zero NDNQI prevalence for four or more consecutive quarters.

Implications for Practice:
Utilizing a shared governance model evidence based guidelines can be developed to prevent and treat pressure ulcers. RNs recognized as wound care subject matter experts/clinicians by their peers provides a culture of safety congruent with the medical center's magnet recognition received in 2011.