Adena Regional Medical Center 2017
PUPS Pressure Ulcer Prevention Staff The team consists of at least two representatives from each of our 7 nursing units and our float pool, two from Pike Adena, two PCAs, a dietician and two nurses from our Adena Wound Care Center outpatient clinic. We do quarterly audits and assess all patients skin and EMR documentation hospital wide and then report the collected data to administration and nurse managers. This team has been in existence since 2006. Our goal is to educate our staff on pressure ulcer/injury prevention measures and to have no HAPI (hospital acquired pressure injuries).
PUPS After each quarterly audit, the team gathers to discuss our findings. Any issues we have noted with improper staging and documentation, the PUPS then take back to their units to share at huddles and staff meetings. They are the unit resource person. After that meeting, we provide additional education to the members. We will often have a guest speaker talk to the group. Ex: We had KCI come in to review proper application and bridging techniques, and Smith & Nephew on properly application of Santyl.
Nursing Clinical Ladder HAPU Hospital Acquired Pressure Ulcer (NQIT) Nursing Quality Improvement Team This group meets every month, and they complete weekly audits that go directly to the nurse manager of the Clinical Ladder team. We also have a Black Belt working with our data collection. We are providing real time education so that errors in documentation can be caught and corrected prior to the patient being discharged and improper coding of the chart to occur.
NQIT - HAPI The NQIT-HAPU team began working with the PUPS Team in 2015. We had 13 HAPU in 2014, and were determined to get those numbers down. With their help in 2015, we were able to cut that number down to 8. Our numbers have continued to decrease with our pressure prevention strategies, and we only had one in 2016.
PUPS & NQIT-HAPU Part of the expectation of this team is to be pro-active and teach their co-workers. Many of them are making posters, creating games to educate and get their staff involved. Wound care and assessments are part of our annual skills fair. We are also getting our PCAs to realize that they are a valued part of the team. They are our eyes and ears, so they need to report issues to the nurse promptly. We are focusing on education specifically for them.
Adena Wound Care Services Pressure Injury education is provided to all new nurses at Adena Nurse Orientation. They are taught: How to recognize and properly stage pressure injuries How to measure wounds properly Complete assessment and documentation of wounds Terminology used to describe wounds Products that are available to treat wounds & skin conditions Nursing interventions to prevent breakdown if at risk The importance of diet and nutrition in the healing of wounds
Braden Scale Completed on admission updated every 24 hrs
EMR Documentation of wounds on admission faster- better compliance
EMR More accurate documentation
EMR Updated with NPUAP 2017 Guidelines
Best Practices
Clinical Practice Guidelines
Clinical Practice Guidelines - Stage 2 Nursing Interventions - Treatment Algorithms
Clinical Practice Guidelines - Stage 3 Nursing Interventions Treatment Algorithms
Clinical Practice Guidelines - Stage 4 Nursing Interventions Treatment Algorithms
Tips to Prevent Pressure Ulcers
Surface Alternatives
Medline Equalizeaire Mattress All beds throughout the facility have air mattresses An optional pump can be added to provide alternating air pressure
Heel Boots Placed For Protection
Wedges use for positioning
Guidelines
Purple for Pretty Skin
Blue for Better Bottoms
Contains Zinc Oxide for use on Excoriated skin (Diarrhea/IAD)
Red May Indicate Fungal Infection Notify the Nurse
Use Wipes instead of soap that dries the skin
Stool Management System