With a new Epic electronic health record system to be installed at WellStar Cobb soon, there will be an embedded alert mechanism for nurses and doctors to signal the beginnings of skin breakdown, Delk says. The alert prompts review and documentation, as well as two-way communication.
Until then, the hospital uses a "pink sheet," with a diagram of the patient showing the areas of concern.
"That allows the physician to go right to that area with the nursing team and make sure they're dealing with the correct area of the body," Delk says.
Other strategies include spending $5 million across the five-hospital WellStar system to purchase special beds, including about 30 beds that use alternating air pulsations to reduce pressure on certain areas and shift the patient's weight around on a schedule that nursing staff can customize.
But one effort the hospital is excited about, Delk says, is a still somewhat experimental Early Mobility Program for all patients in the intensive care unit, including those on ventilators. Launched by Johns Hopkins researchers, the program requires staff to devote time with ICU patients to get them up and moving, actually walking, even while on ventilators, she says.
So far, the program has not only reduced pressure ulcer formations in the ICU, but also seems to have increased muscle strength, reduced pulmonary complications in this high-risk population, and increased their alertness because sedation is decreased during the process.
"Patients who can get up and participate seem to enjoy it. Even though they don't enjoy being sick, it gives them a very positive attitude that they are making progress," Delk says.
Delk adds that there have been no pressure ulcers, according Johns Hopkins' most recent report covering 2010 to 2012.