2.50
Hdl Handle:
http://hdl.handle.net/10755/154623
Type:
Presentation
Title:
Using Evidence to Promote Skin Integrity
Abstract:
Using Evidence to Promote Skin Integrity
Conference Sponsor:Sigma Theta Tau International
Conference Year:2003
Conference Date:July 9, 2003
Author:Hitchings, Kim Suzanne, RN, MSN
P.I. Institution Name:Lehigh Valley Hospital and Health Network
Title:Director, Center for Professional Excellence
Objective: Nosocomial pressure ulcers result in physical and emotional distress for patients and increased health care time and resources. In response to the 1999 Institute of Medicine Report, “To Err is Human,” our hospital initiated 15 teams to reduce errors, including one to decrease nosocomial pressure ulcers. Design: Team members critically analyzed the literature. Best practice was associated with identifying patients at risk for skin breakdown using the Braden Scale, versus another scale we were using. The literature and peformance improvement data also prompted a major revision to our Skin Integrity Care Standards. Population: Patients are assessed using the Braden Scale upon admission and then daily. Concept: Based upon the Braden assessment, the Skin Integrity Standards are implemented. Standards permit the nurse to implement specific treatment guidelines for skin tears and Stage 1 ulcers, and include a decision tree describing the indications for specialty beds. Methods: Post implementation, we focused on process evaluation. Team members used an inter-rater reliability method to evaluate if nurses completed the Braden scale and instituted associated skin care standards correctly. Results showed 71% compliance with daily Braden Scale scoring and 41% incidence of correct Braden Scale scoring. Multiple, ongoing strategies have been implemented to improve this data. Findings: The overall rate for nosocomial pressure ulcers has continuously declined. The rates for 5 of the last 6 months were at or below control limits. Conclusions: Evidence prompted a change in our skin assessment tool and Skin Integrity Standards of Care. This change was associated with a decreasing trend in nosocomial ulcer rates. Implications: Evidence-based practice changes must consider process as well as outcome evaluation. Our staff nurses are conducting monthly process evaluations of compliance with and correctness of Braden Scale scoring, with intent to improve the same and thus, further decrease nosocomial pressure ulcers.
Repository Posting Date:
26-Oct-2011
Date of Publication:
9-Jul-2003
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleUsing Evidence to Promote Skin Integrityen_GB
dc.identifier.urihttp://hdl.handle.net/10755/154623-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Using Evidence to Promote Skin Integrity</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July 9, 2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Hitchings, Kim Suzanne, RN, MSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Lehigh Valley Hospital and Health Network</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Director, Center for Professional Excellence</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Kim.Hitchings@lvh.com</td></tr><tr><td colspan="2" class="item-abstract">Objective: Nosocomial pressure ulcers result in physical and emotional distress for patients and increased health care time and resources. In response to the 1999 Institute of Medicine Report, &ldquo;To Err is Human,&rdquo; our hospital initiated 15 teams to reduce errors, including one to decrease nosocomial pressure ulcers. Design: Team members critically analyzed the literature. Best practice was associated with identifying patients at risk for skin breakdown using the Braden Scale, versus another scale we were using. The literature and peformance improvement data also prompted a major revision to our Skin Integrity Care Standards. Population: Patients are assessed using the Braden Scale upon admission and then daily. Concept: Based upon the Braden assessment, the Skin Integrity Standards are implemented. Standards permit the nurse to implement specific treatment guidelines for skin tears and Stage 1 ulcers, and include a decision tree describing the indications for specialty beds. Methods: Post implementation, we focused on process evaluation. Team members used an inter-rater reliability method to evaluate if nurses completed the Braden scale and instituted associated skin care standards correctly. Results showed 71% compliance with daily Braden Scale scoring and 41% incidence of correct Braden Scale scoring. Multiple, ongoing strategies have been implemented to improve this data. Findings: The overall rate for nosocomial pressure ulcers has continuously declined. The rates for 5 of the last 6 months were at or below control limits. Conclusions: Evidence prompted a change in our skin assessment tool and Skin Integrity Standards of Care. This change was associated with a decreasing trend in nosocomial ulcer rates. Implications: Evidence-based practice changes must consider process as well as outcome evaluation. Our staff nurses are conducting monthly process evaluations of compliance with and correctness of Braden Scale scoring, with intent to improve the same and thus, further decrease nosocomial pressure ulcers.</td></tr></table>en_GB
dc.date.available2011-10-26T13:08:47Z-
dc.date.issued2003-07-09en_GB
dc.date.accessioned2011-10-26T13:08:47Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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