Skin Champions: Save Our Skin

Purpose:
The goal of the skin champion program is to intially reduce the number of hospital acquired pressure ulcers. The sustainment goal of the skin champion program is the prevention of hospital acquired pressure ulcers.

Relevance/Significance:
Safety is a concern for every hospitalized patient. Patients should not come into the hospital and develop preventable pressure ulcers. Aligning care practice to improve outcomes in our patients leads to safe, quality care. Using quality data, defining and addressing areas of opportunity for improvement is instrumental. Hospital acquired pressure ulcers (HAPU) have long reaching effects on patients, caregivers, and hospital's cost of care and can lead to other issues such as pain and infection.

Strategy and Implementation:
An interprofessional team was brought together to address HAPU and develop a program of prevention and education. The program implemented was the skin champion. Skin champions work as a team to "save our skin". They advocate for patients, educate staff, patients, patients' family, and physicians to the prevention of hospital acquired pressure ulcers. They serve as experts and provide consultation to staff regarding high risk patients or those who develop HAPU. Steps taken using a PDCA cycle: 1 Identified the problem: what put patient's at risk 2 Identified education needs 3 established resources: hotline, email address, experts 3 Expanded interdepartmental collaboration: added OR participation, nursing informatics,PT/OT 4 Increased efforts to reach goal: expanded role of wound care RN, evaluated supplies and beds, conducted monthely roadshows to educate all staff not just nursing 5 expanded education opportunities and initatives for prevention

Evaluation:
Monitored weekly pressure ulcer rates. Used monthly pressure ulcer prevalence rates to track and trend the issue. Should an improvement from 12% to 0% in first year of the program. Continue to monitor in the same way. Each pressure ulcer that occurs is investigated to determine if all possible preventative methods where used. The team uses trended data to determine the need for further change.

Implications for Practice:
Proactive evaluation, assessment, intervention, and education are key to the prevention of HAPU. The skin is the largest organ in the body, but is oftern overlooked by nursing staff. Understanding the impact of pressure ulcers and preventionof HAPU is paramount to safe, quality nursing practice.