title: Nosocomial pressure ulcer rates in critical care: performance improvement project.
abstract: Assessment, monitoring, and prevention of pressure ulcers in the hospitalized patient are required standards of care. The annual nosocomial pressure ulcer (NPU) rates for the adult intensive care units at our facility had trended up to 33% from 14% over a 13-month period. Our performance improvement team decided to track 5 variables that may have contributed to the increased incidence of NPU. Weekly skin care rounds were conducted to collect data, educate staff, and reinforce skin care policy and standards of care. Data analysis revealed 3 areas that required further emphasis with nursing staff: daily assessment with the Braden Scale, prevention of NPU beginning on the day of hospital admission, and the effect of sedation on patient mobility. Implementation of appropriate interventions targeted to specific Braden subscales needs to be included in the plan of care.
authors.affiliation: Indiana University Hospital (IU), Clarian Health Partners, Indianapolis, IN 46202, USA. cwolvert@Clarian.org
authors.forename: Cheryl Lynn
authors.initials: CL
authors.lastname: Wolverton
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Hobbs
authors.forename: Terrie
authors.initials: T
authors.lastname: Beeson
authors.forename: Marianne
authors.initials: M
authors.lastname: Benjamin
authors.forename: Karen
authors.initials: K
authors.lastname: Campbell
authors.forename: Charlie
authors.initials: C
authors.lastname: Forbes
authors.forename: Nicole
authors.initials: N
authors.lastname: Huff
authors.forename: Michelle
authors.initials: M
authors.lastname: Kieninger
authors.forename: Michael
authors.initials: M
authors.lastname: Luebbehusen
authors.forename: Mary
authors.initials: M
authors.lastname: Myers
authors.forename: Susan
authors.initials: S
authors.lastname: White
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D016292:Procedural Sedation / Q000009:adverse effects; D003422:Critical Care / Q000379:methods* / Q000592:standards; D003625:Data Collection; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States / Q000453:epidemiology; D020380:Needs Assessment; D009730:Nursing Assessment / Q000379:methods / Q000592:standards; D009731:Nursing Audit; D015403:Nursing Evaluation Research; D010347:Patient Care Planning; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000209:etiology / Q000451:nursing / Q000517:prevention & control*; D011367:Professional Staff Committees / Q000458:organization & administration; D018570:Risk Assessment; D012307:Risk Factors; D017749:Total Quality Management / Q000458:organization & administration*