2.50
Hdl Handle:
http://hdl.handle.net/10755/157012
Category:
Abstract
Type:
Presentation
Title:
Turning Under Pressure: Improving Pressure Ulcer Rates in the Cardiovascular ICU
Author(s):
Macapagal, Rosario P.; Knaack, Kathleen
Author Details:
Rosario P. Macapagal, RN,BS,CCRN, The Methodist Hospital, Houston, Texas, USA, email: rmacapagal@tmhs.org; Kathleen Knaack
Abstract:
PURPOSE: Pressure ulcers are a serious consequence and create a 50% increase in nursing work. It can lead to sepsis, which increases hospital costs and morbidity and mortality rates. A staggering 35% pressure ulcer rate in our cardiovascular ICU (CVICU) led to the development and implementation of a well-designed process aimed to decrease and ensure low incidence of hospital-acquired pressure ulcers. DESCRIPTION: The CVICU shared governance committee assessed the unitÆs clinical practice related to pressure ulcers. The committee evaluated 3 areas: documentation of Braden scale per hospital standards, observation of patient turning on a regular basis, and nursesÆ understanding of pressure ulcer incidence and their treatments. The documentation of Braden scale was at 98% compliance. The assessment of actual practice of turning was below standard and the third factor of knowledge related to pressure ulcer was determined to be deficient based on the number of referrals to the hospital skin care specialist. Recommendations were twofold: education of all ICU mentors to become wound care resources and revision of the patient care assistant (PCA) role in the ICU to focus on patient turning. A 4-hour class with emphasis on skin surveillance and treatment was attended by ICU mentors. Two PCAs on day and night shifts were assigned solely to turn patients every 2 hours or mobilize them out of bed with nursing supervision. Nurses identified high-risk patients and provided timely intervention. The operating room staff were recruited to apply air mattress to beds for critically ill patients with special devices before they come out to our unit. EVALUATION/OUTCOMES:The CVICU pressure ulcer rate dropped to 15% following the initial changes in the patient care assistant role and staff education. Weekly pressure ulcer surveillance audit showed fluctuation of pressure ulcer rates correlating with patient acuity. The Braden scale assessment was expanded to every shift for closer skin surveillance. Nurses have taken the initiative to provide appropriate interventions resulting in decreased referrals, and collaboration with the operating room staff contributed to our unit's decreased incidence of pressure ulcers. As of October 7, 2009, our pressure ulcer rate is at 8.1%, well below the national benchmark.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866
Conference Date:
2010
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleTurning Under Pressure: Improving Pressure Ulcer Rates in the Cardiovascular ICUen_GB
dc.contributor.authorMacapagal, Rosario P.en_GB
dc.contributor.authorKnaack, Kathleenen_GB
dc.author.detailsRosario P. Macapagal, RN,BS,CCRN, The Methodist Hospital, Houston, Texas, USA, email: rmacapagal@tmhs.org; Kathleen Knaacken_GB
dc.identifier.urihttp://hdl.handle.net/10755/157012-
dc.description.abstractPURPOSE: Pressure ulcers are a serious consequence and create a 50% increase in nursing work. It can lead to sepsis, which increases hospital costs and morbidity and mortality rates. A staggering 35% pressure ulcer rate in our cardiovascular ICU (CVICU) led to the development and implementation of a well-designed process aimed to decrease and ensure low incidence of hospital-acquired pressure ulcers. DESCRIPTION: The CVICU shared governance committee assessed the unitÆs clinical practice related to pressure ulcers. The committee evaluated 3 areas: documentation of Braden scale per hospital standards, observation of patient turning on a regular basis, and nursesÆ understanding of pressure ulcer incidence and their treatments. The documentation of Braden scale was at 98% compliance. The assessment of actual practice of turning was below standard and the third factor of knowledge related to pressure ulcer was determined to be deficient based on the number of referrals to the hospital skin care specialist. Recommendations were twofold: education of all ICU mentors to become wound care resources and revision of the patient care assistant (PCA) role in the ICU to focus on patient turning. A 4-hour class with emphasis on skin surveillance and treatment was attended by ICU mentors. Two PCAs on day and night shifts were assigned solely to turn patients every 2 hours or mobilize them out of bed with nursing supervision. Nurses identified high-risk patients and provided timely intervention. The operating room staff were recruited to apply air mattress to beds for critically ill patients with special devices before they come out to our unit. EVALUATION/OUTCOMES:The CVICU pressure ulcer rate dropped to 15% following the initial changes in the patient care assistant role and staff education. Weekly pressure ulcer surveillance audit showed fluctuation of pressure ulcer rates correlating with patient acuity. The Braden scale assessment was expanded to every shift for closer skin surveillance. Nurses have taken the initiative to provide appropriate interventions resulting in decreased referrals, and collaboration with the operating room staff contributed to our unit's decreased incidence of pressure ulcers. As of October 7, 2009, our pressure ulcer rate is at 8.1%, well below the national benchmark.en_GB
dc.date.available2011-10-26T19:20:35Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:20:35Z-
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.conference.date2010en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationWashington, D.C., USAen_GB
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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