J Clin Outcomes Manage
Skinsational skin care' to reduce the incidence and severity of pressure ulcers in hospitalized patients
Tiller SJ, Wilds TA
Abstract Objective: To describe the design and implementation of a performance improvement project to reduce the incidence and severity of pressure ulcers. Setting: Emory Healthcare, a multihospital system comprising 2 acute care hospitals, an extended care facility, and a geriatric hospital. Methods: The FOCUS-PDCA (Find, Organize, Clarify, Understand, Select and Plan-Do-Check-Act) methodology was used. A team was appointed to review current processes and develop a systematic approach to evaluating patients at risk for developing pressure ulcers. A skin care algorithm, skin assessment flowsheet, and wound care flowsheet were created and piloted for 1 month on selected nursing units and then rolled out to all inpatient units in September 2004. Results: After 9 months, relative risk for incidence of pressure sores decreased by 3% and 5% at the acute care hospitals and 6% at the extended care hospital. The geriatric hospital rate remained at 0%. The average adherence rate among the 9 pilot units for using wound prevention tools was 85%. Conclusion: The use of standardized tools and doc-umentation practices for evaluating patients at risk for developing pressure ulcers resulted in a reduction of incidence of pressure ulcers in a high-risk patient population.
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