title: Use of a Comprehensive Program to Reduce the Incidence of Hospital-Acquired Pressure Ulcers in an Intensive Care Unit.
abstract: BACKGROUND
  Hospital-acquired pressure ulcers (HAPUs) are a costly and largely preventable complication occurring in a variety of acute care settings. Because they are considered preventable, stage III and IV HAPUs are not reimbursed by Medicare.
  
  
  OBJECTIVE
  To assess the effectiveness of a formal, year-long HAPU prevention program in an adult intensive care unit, with a goal of achieving at least a 50% reduction in 2013, compared with 2011.
  
  
  METHODS
  Planning for the prevention program began in 2012, and the program was rolled out in the first quarter of 2013. Program components included use of Braden scores, a revised skin care protocol, fluidized repositioners, and silicone gel adhesive dressings. Efforts were made to educate and motivate staff and encourage them to be more proactive in detecting patients at risk of HAPUs.
  
  
  RESULTS
  Incidence of HAPUs in the unit was reduced by 69% (n = 17; 3% of patients in 2013 vs n = 45, 10% of patients in 2011), despite a 22% increase in patient load. The potential cost saving as a result of this decrease was approximately $1 million.
  
  
  CONCLUSIONS
  A comprehensive, proactive, collaborative ulcer prevention program based on staff education and a focus on adherence to protocols for patient care can be an effective way to reduce the incidence of HAPUs in intensive care units.
authors.affiliation: Katie Swafford is a critical care clinical nurse specialist and Rachel Culpepper and Christina Dunn are staff nurses and shift coordinators in the critical care unit at Eskenazi Health, Indianapolis, Indiana. katie.swafford@eskenazihealth.edu.
authors.forename: Katie
authors.initials: K
authors.lastname: Swafford
authors.affiliation: Katie Swafford is a critical care clinical nurse specialist and Rachel Culpepper and Christina Dunn are staff nurses and shift coordinators in the critical care unit at Eskenazi Health, Indianapolis, Indiana.
authors.forename: Rachel
authors.initials: R
authors.lastname: Culpepper
authors.affiliation: Katie Swafford is a critical care clinical nurse specialist and Rachel Culpepper and Christina Dunn are staff nurses and shift coordinators in the critical care unit at Eskenazi Health, Indianapolis, Indiana.
authors.forename: Christina
authors.initials: C
authors.lastname: Dunn
mesh_terms: D064648:Critical Care Nursing / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D003668:Pressure Ulcer / Q000517:prevention & control*