Skin Team Redesign

Purpose:
The redesign of the Skin Team at UPMC St. Margaret was undertaken to improve patient outcomes, to move towards a transparent Nursing Quality Skin Program at UPMC St. Margaret, and to decrease the number of pressure ulcers at UPMC St. Margaret.

Significance:
Pressure ulcers are costly both the patient and to a health care organization. The development of a pressure ulcer can decrease the quality of a patient's life; in addition, to adding costs of providing care for a health care organization.

Strategy and Implementation:
The nurse educator and the wound care nurses provided education to the skin representatives, the skin representatives participated in the National Database for Nursing Quality Indicators (NDNQI)Pressure Ulcer Training available through the NDNQI website. In addition, staging reference cards that include treatment options for the pressure ulcer and skin care product reference cards were developed and distributed to the skin representatives. The increased education of the Skin Reps has enabled these individuals to be viewed as the “expert” and “resource” person on their units. The Skin Team redesigned included increasing the frequency of the Skin Prevalence audits from quarterly to monthly thereby increasing the opportunities for identification of issues/concerns and increasing the transparency of the skin prevalence audits results

Evaluation:
The Skin Team Redesign has enabled UPMC St. Margaret to outperform NDNQI's benchmark for bed size and Magnet facility. Also,the skin prevalence led to the identification of the need to address pressure ulcers related to respiratory devices, which lead to a collaborative effort with Respiratory.

Implications for Practice:
The Skin Team redesigned included increasing the frequency of the Skin Prevalence audits from quarterly to monthly thereby increasing the opportunities for identification of issues/concerns and increasing the transparency of the skin prevalence audits results.