Pressure is On to Reduce Pressure Ulcers

Cheryl Clark, for HealthLeaders Media , November 21, 2013

Other efforts include expanding nutritional assessments and using a silicon-based foam dressing on certain parts of the body prophylactically, regardless of whether skin breakdown has begun, to act as a moisture barrier that protects the skin.

"We're now thinking of expanding the use of this product beyond the ICU to other patients in the hospital because we've had such good results," she says.

Delk emphasizes that the WellStar system has been traveling on its quality improvement journey at a faster pace in recent years to improve care for its patients.

"But if there was a turning point, it was the review of the data [on HACs] that focused our efforts on where we need to prioritize and improve. We're not perfect, but we are first to say we are on a journey that involves constantly looking at our data to tell us where we should focus," Delk says.

At Crouse and other hospitals, strategies are not piecemeal, with different teams or individuals addressing each of the HACs. It isn't like one group assesses fall risk and another makes sure there isn't a central line bloodstream infection and another group worries about urinary catheter use.

Rounding with physicians and staff includes assessments of all these risks at the same time, says Watkins. "Our efforts are encompassing to get staff to pay attention to what's going on with the patient at all levels so we reduce all hospital-acquired conditions."

And it's important not to let efforts stop once a hospital starts to see success, Suehs adds.

"A lot of places will say, 'Good, for the past three months we've been able to do this.' They declare victory.

"I think one of our successes is that we don't declare victory, even after nine months. We're waiting for a year and a half before we actually say we've made a difference. We want to make sure that our changed habits and technology are embedded in our care."

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This article appears in the November issue of HealthLeaders magazine.

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5 comments on "Pressure is On to Reduce Pressure Ulcers"

David Sutterfield (12/6/2013 at 8:06 AM)
All the Mount Sinai Hospital study seems to state is that the risk of developing a PU increases as the number of co-morbidities increases. That has been known for years. The UTH study noted in this issue makes a case that it is still about relieving pressure and other preventive care, noting they achieved a high rate of success with use of high density foam mattresses. If the MSH study had any validity, then one would not see the wide ranges of outcomes between facilities with bad facilities having consistently bad outcomes and good facilities having consistently good outcomes.

Karen Bry (12/4/2013 at 11:32 AM)
The Wound Care Team at Mount Sinai Hospital in Chicago conducted research investigating the link between hospital acquired pressure ulcer (HAPU) development and co-morbidity. We found that persons who developed HAPU (despite having all recommended prevention)had an average of 9.25 major co-morbid conditions Skin Failure literature discusses the physiology of skin death. Skin Fails too....we need to optimize prevention, invest in the best bed surfaces and prevention devices and ......stop blaming the nurses!

Bonnie Altman (12/4/2013 at 9:51 AM)
PS Hospital Admin. is partially at fault. Hire more nurses and higher quality nurses and nursing staff. Offer better in house edu. ongoing. Put your money and your investment in your nurses and reduce the "need" for unnecessary, prolonged analysis.




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