2.50
Hdl Handle:
http://hdl.handle.net/10755/157428
Type:
Presentation
Title:
Pressure Ulcer Protocol Implementation Outcomes
Abstract:
Pressure Ulcer Protocol Implementation Outcomes
Conference Sponsor:Western Institute of Nursing
Conference Year:2005
Author:Keith, Jeannie, RN, MSN, AOCN
P.I. Institution Name:Providence Alaska Medical Center
Co-Authors:Jill Janke, Dorothy Kinley, Mary Thompson, Sandy Gunter
Background: Pressure ulcers cause pain and suffering, affect quality of life, and increase cost of patient care. It is estimated that hospital acquired pressure ulcers cost 2.2 to 3.6 billion dollars annually. Nationally, the prevalence of hospital acquired pressure ulcers is estimated at 10%, with a range of 2% to 29% between facilities and between types of patients. As a nursing sensitive outcome, their occurrence is often used as a quality of care indicator. According to the Agency for Health Care Policy and Research (1994) most pressure ulcers can be prevented, especially when evidence based guidelines are integrated into practice. Development and implementation of a guideline is the first step toward reducing hospital acquired pressure ulcers. A pressure ulcer prevalence survey should be done pre and post guideline implementation to provide a measure of the guidelines success. Purpose/Goal: The purpose of this outcomes research project was to evaluate the effectiveness of a newly implemented evidence based pressure ulcer protocol. Specifically, the study was designed to answer the following research question: What effect does implementation of an evidence based pressure ulcer protocol have on the incidence of hospital acquired pressure ulcers in an adult population admitted to an acute care facility? Method: Prior to implementation of the guideline, baseline data on the incidence of hospital acquired pressure ulcers was collected. During this time, patients received care according to existing policies. All adult in-patients admitted to the acute care facility on a given day were assessed by nurses trained in the research protocol. If an ulcer was present (grade I to grade 4) a chart review was done to determine if the ulcer had been present on admission. If there was no notation on the admission physical, the patient was classified as having a hospital acquired pressure ulcer. While baseline data was being collected, a multi-disciplinary committee developed a new evidence based pressure ulcer guideline. The protocol required all patients to have documented skin assessments on admission and q 24 hours thereafter. Standard definitions were used to stage all skin lesions (I, II, III, or IV). The Braden Scale for Predicting Pressure Sore Risk was filled out for each patient. This instrument consists of six subscales that examine sensory perception, skin moisture, activity, mobility, friction and shear, and nutritional status. A total of 6 to 23 points is possible, with lower scores indicating higher risk. Based on the risk score, a prevention and/or treatment plan was initiated. An intensive staff education program was carried out. This education was designed to provide staff with the knowledge and skills for detailed skin assessment, patient risk factors, and strategies for prevention, early detection and treatment of pressure ulcers. Seven months after implementation of the new guideline, data on the incidence of hospital acquired pressure ulcers will be collected for comparison purposes. In addition a chart review will be done to determine if the protocol compliance rates. Results: Baseline data was collected on 157 adult patients. The number of patients with facility acquired pressure ulcers was 25 (15.3%). Fifty-eight percent of the ulcers were stage I, and 42% stage II. Evaluative data will be collected in January, 2005.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePressure Ulcer Protocol Implementation Outcomesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157428-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Pressure Ulcer Protocol Implementation Outcomes</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Keith, Jeannie, RN, MSN, AOCN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Providence Alaska Medical Center</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jkeith@provak.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Jill Janke, Dorothy Kinley, Mary Thompson, Sandy Gunter</td></tr><tr><td colspan="2" class="item-abstract">Background: Pressure ulcers cause pain and suffering, affect quality of life, and increase cost of patient care. It is estimated that hospital acquired pressure ulcers cost 2.2 to 3.6 billion dollars annually. Nationally, the prevalence of hospital acquired pressure ulcers is estimated at 10%, with a range of 2% to 29% between facilities and between types of patients. As a nursing sensitive outcome, their occurrence is often used as a quality of care indicator. According to the Agency for Health Care Policy and Research (1994) most pressure ulcers can be prevented, especially when evidence based guidelines are integrated into practice. Development and implementation of a guideline is the first step toward reducing hospital acquired pressure ulcers. A pressure ulcer prevalence survey should be done pre and post guideline implementation to provide a measure of the guidelines success. Purpose/Goal: The purpose of this outcomes research project was to evaluate the effectiveness of a newly implemented evidence based pressure ulcer protocol. Specifically, the study was designed to answer the following research question: What effect does implementation of an evidence based pressure ulcer protocol have on the incidence of hospital acquired pressure ulcers in an adult population admitted to an acute care facility? Method: Prior to implementation of the guideline, baseline data on the incidence of hospital acquired pressure ulcers was collected. During this time, patients received care according to existing policies. All adult in-patients admitted to the acute care facility on a given day were assessed by nurses trained in the research protocol. If an ulcer was present (grade I to grade 4) a chart review was done to determine if the ulcer had been present on admission. If there was no notation on the admission physical, the patient was classified as having a hospital acquired pressure ulcer. While baseline data was being collected, a multi-disciplinary committee developed a new evidence based pressure ulcer guideline. The protocol required all patients to have documented skin assessments on admission and q 24 hours thereafter. Standard definitions were used to stage all skin lesions (I, II, III, or IV). The Braden Scale for Predicting Pressure Sore Risk was filled out for each patient. This instrument consists of six subscales that examine sensory perception, skin moisture, activity, mobility, friction and shear, and nutritional status. A total of 6 to 23 points is possible, with lower scores indicating higher risk. Based on the risk score, a prevention and/or treatment plan was initiated. An intensive staff education program was carried out. This education was designed to provide staff with the knowledge and skills for detailed skin assessment, patient risk factors, and strategies for prevention, early detection and treatment of pressure ulcers. Seven months after implementation of the new guideline, data on the incidence of hospital acquired pressure ulcers will be collected for comparison purposes. In addition a chart review will be done to determine if the protocol compliance rates. Results: Baseline data was collected on 157 adult patients. The number of patients with facility acquired pressure ulcers was 25 (15.3%). Fifty-eight percent of the ulcers were stage I, and 42% stage II. Evaluative data will be collected in January, 2005.</td></tr></table>en_GB
dc.date.available2011-10-26T19:51:50Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:51:50Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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