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Nurses Find New Ways to Combat Pressure Ulcers

Nurses Find New Ways to Combat Pressure Ulcers

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New tactics for combatting pressure ulcers.

Nurses in Indiana have created a new method to reduce pressure ulcer prevalence.

Data from the National Pressure Ulcer Advisory Panel paints a rather stark portrait of hospital-acquired pressure ulcers (HAPU). Each year, some 2.5 million patients across a number of health settings (including acute, home and long-term care) suffer from a HAPU.

Given the prevalence of these potentially life-threatening pressure ulcers, health care institutions across the country have taken more measures in recent years to stem the tide. Between 2011 and 2014, the Hospital Engagement Network launched a change package, including new protocols for measurement and patient engagement that helped prevent 4,655 HAPUs.

Now, nurses from Indiana’s Eskenazi Health Center have unveiled a new plan for tackling HAPUs with similarly striking results.

Saving skin

The plan – detailed in a recent edition of the American Journal of Critical Care – revealed that the team of nurses cut the rate of pressure ulcers by 50 percent and saved EHC $700,000.

To better address HAPUs, EHC ​nurses launched the “Save our Skin Project.” The plan saw the implementation of several new tactics and stop-gaps, including annual education, new skin care protocol, a new camera and working together in pairs to help one another. They also took steps to streamline the treatment process, like placing important tools closer to each nurse.

Another important implementation was the use of the Braden Algorithm, which the nursing staff detailed in full during the American Association of Critical-Care Nurses 2016 National Teaching Institute and Critical Care Exposition in mid-May 2016 The algorithm scores a patients’ risk for skin-related damage, and gives nurses guidelines to follow – like elevating heels or implementing massage – to better treat the affected areas.

However, perhaps the biggest component of “Save our Skin” was changing the way nurses operated. Speaking to Medscape Medical News, lead author Christina Dunn said it was a huge endeavor just to get nurses to fully consider HAPUs.

“It’s been almost a three-year process. Today, for most of the nurses in our hospital, attention to hospital-acquired pressure ulcers has become part of daily care,” she explained. “But we do annual education to keep nurses thinking about it.”

But all the hard work has paid off in spades. Between 2011 and 2013, the rate of HAPUs at EHC dropped 69 percent, from 45 patients to just 17. This is especially impressive considering EHC also increased its patient load by 22 percent.

Even with that success, the team is still aware that some pressure ulcers are simply unavoidable, such as high-risk patients who have encountered stabbings or car accidents. However, Chris Chrisman, an RN from Penn State Milton S. Hershey Medical Center, told MMN that projects like EHC’s get nurses thinking, and that’s a huge first step for proper wound care.


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