Helen Pallares Janiec
Point Loma Nazarene Unversity, USA
Title: Wound team clinical skin rounding in the intensive care unit to decrease hospital acquired pressure ulcer rates
Biography
Biography: Helen Pallares Janiec
Abstract
Background/Problem: The occurrence of Hospital Acquired Pressure Ulcers (HAPU) reflects upon nursing care effectiveness and is seen as a nursing quality outcome measure. HAPUs are a global concern due to many factors and contribute to an increase in treatment costs, increase length of stay, possible litigation, and reimbursement issues. HAPU are seen as a preventable adverse event as identified by Centers for Medicare and Medicaid services (CMS) in the United States. Data gathered before initiation of this project indicated within a 12-month period, that the ICU demonstrated a HAPU rate of 27% of the total HAPU occurrences in the hospital. Goal Statement: Among intensive care patients would daily clinical skin assessment rounding, done with a wound nurse specialist and bedside nurse, versus current standard practice, decrease Hospital Acquired Pressure Ulcer rates? Innovation: Utilized the 8 A’s Evidence-based Practice Consortium for Nursing Excellence Model, as well as the United States National Pressure Ulcer Advisory Panel Staging System as a guide for this project. The certified wound specialist rounded on each ICU patient with the assigned critical care nurse and made focused Head-to-Toe assessments. Informal teaching by the wound specialist was provided at the bedside with guidance on recommendations for pressure relieving interventions, disease process risk, and proper identifiable staging. Outcome: Assessment of 450 patients demonstrated no identified stage II or higher HAPUs and a clinically relevant reduction in the incidence of pressure ulcers during the project period. Benefits to patients included improved skin surveillance interventions and early HAPU detection.