Nosocomial pressure ulcer rates in critical care: performance improvement project.
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.
Wolverton
Cheryl Lynn
CL
Indiana University Hospital (IU), Clarian Health Partners, Indianapolis, IN 46202, USA. cwolvert@Clarian.org
Hobbs
Lisa A
LA
Beeson
Terrie
T
Benjamin
Marianne
M
Campbell
Karen
K
Forbes
Charlie
C
Huff
Nicole
N
Kieninger
Michelle
M
Luebbehusen
Michael
M
Myers
Mary
M
White
Susan
S
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*