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Informational/Educational Report
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One good turn deserves another: the prevention of nosocomial pressure ulcers at a community hospital Ann Roney, RN, BSN, MS, CHCNS, CWOCN, Mary Towe, RN, BSN, MBA, Washington County Hospital, Hagerstown, MD Purpose of intervention: More than 1 million individuals develop pressure ulcers each year. There is approximately 1.5 to 3 million adults currently living with pressure ulcers in the United States. An average of $2.2 to $6 billion dollars yearly is associated with health care dollars spent in the acute care setting. It is imperative that healthcare professionals implement prevention programs that identify high risk individuals and implement preventative measure before pressure ulcers begin. Discussion of process: The ÒWound Collaborative Practice TeamÓ was charged with developing an intervention that would decrease the number of hospital acquired pressure ulcers to below national average. Membership included a general surgeon, nursing representatives from all inpatient units, rehabilitation, and nutrition..Learning objectives were as follow:.*Identify at risk individuals for development of pressure ulcers.*Design evidence-based interventions for the prevention and treatment of pressure ulcers.*Analyze criteria for the utilization of support surfaces..An educational initiative was begun on pressure ulcer prevention and treatment. Staff was educated in identifying patients at risk with the Norton Pressure Ulcer Risk Assessment (PURA) tool, implementing appropriate strategies to attain/maintain intact skin, prevent complications, promptly identify or manage complications, involve patient in self management and implement cost effective plans that prevent and treat pressure ulcers..Evaluation of Outcomes: Participation in a national prevalence ulcer study in March, 2003 demonstrated a 17.1% facility acquired pressure ulcer rate. The national rate for acute care facilities was 7%. Monthly prevalence studies were implemented with feedback to all staff routinely on results as well as continued staff education based on areas that were identified as educational needs. Our current facility acquired rate has dropped significantly to 5.8%, 1.9% below the 2004 national rate of 7.7%. Pressure ulcers in adults: prediction and prevention. Agency for Health Care Policy and Research, US Department of Health and Human Services. (AHCPR publication No. 92Ð0047). Rockville, MD:1992 Beckrich K, Aronovitch S. Hospital-acquired pressure ulcers: a comparison of costs in medical vs. surgical patients. Nurs Economics. 1999;17(5):263Ð271 Eckman K. The prevalence of dermal ulcers among persons in the US who have died. Decubitus. 1989;2(2):36Ð40 Wound, Ostomy, and Continence Nurses Society. Guideline for prevention and management of pressure ulcers, 2003. |
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