title: Improving Outcomes by Implementing a Pressure Ulcer Prevention Program (PUPP): Going beyond the Basics.
abstract: A multidisciplinary process improvement program was initiated at the University of Miami Hospital (UMH) in 2009 to identify the prevalence of hospital-acquired pressure ulcers (HAPU) at the institution and to implement interventions to reduce the incidence of HAPU. This deliberate and thoughtful committee-driven process evaluated care, monitored results, and designed evidence-based strategic initiatives to manage and reduce the rate of HAPU. As a result all inpatient beds were replaced with support surfaces, updated care delivery protocols were created, and monitored, turning schedules were addressed, and a wound, ostomy, and continence (WOC) nurse and support staff were hired. These initial interventions resulted in a decrease in the prevalence of HAPU at UMH from 11.7% of stage II to IV ulcers in the second quarter, 2009 to 2.1% the third quarter. The rate remained at or near the 2009 UMH benchmark of 3.1% until the first quarter of 2012 when the rate rose to 4.1%. At that time new skin products were introduced into practice and continuing re-education was provided. The rate of HAPU dropped to 2.76% by the second quarter of 2012 and has remained steadily low at 1%-2% for nine consecutive quarters.
authors.affiliation: University of Miami Hospital, Miami FL, 1400 NW 12th Avenue, Miami, FL 33136, USA. a.cano11@med.miami.edu.
authors.forename: Amparo
authors.initials: A
authors.lastname: Cano
authors.affiliation: School of Nursing and Health Studies, University of Miami, Brunson Drive, Coral Gables, FL 33146, USA. d.anglade@miami.edu.
authors.forename: Debbie
authors.initials: D
authors.lastname: Anglade
authors.affiliation: University of Miami Hospital, Miami FL, 1400 NW 12th Avenue, Miami, FL 33136, USA. HStamp@med.miami.edu.
authors.forename: Hope
authors.initials: H
authors.lastname: Stamp
authors.affiliation: University of Miami Hospital, Miami FL, 1400 NW 12th Avenue, Miami, FL 33136, USA. FJoaquin@med.miami.edu.
authors.forename: Fortunata
authors.initials: F
authors.lastname: Joaquin
authors.affiliation: University of Miami Hospital, Miami FL, 1400 NW 12th Avenue, Miami, FL 33136, USA. JLopez13@med.miami.edu.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Lopez
authors.affiliation: University of Miami Hospital, Miami FL, 1400 NW 12th Avenue, Miami, FL 33136, USA. LLupe@med.miami.edu.
authors.forename: Lori
authors.initials: L
authors.lastname: Lupe
authors.affiliation: Department of Pharmaceutical Sciences, Northeast Ohio Medical University, Rootstown, OH 44272, USA. sschmidt@neomed.edu.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Schmidt
authors.affiliation: Department of Physical Therapy, University of Nevada Las Vegas, 4505 Maryland Pkwy., Box 453029, Las Vegas, NV 89154, USA. daniel.young@unlv.edu.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Young
keywords: hospital-acquired pressure ulcers; pressure ulcer prevention; pressure ulcer prevention education; skin care