2.50
Hdl Handle:
http://hdl.handle.net/10755/164203
Category:
Abstract
Type:
Presentation
Title:
Empowering Nursing Autonomy with Skin Care
Author(s):
Jackson, Kathryn; McCubbin, Lena
Author Details:
Kathryn Jackson, RN, CNS, CRRN, Columbus Regional Hospital, Columbus, Indiana, USA, email: nacnsorg@nacns.org; Lena McCubbin, MS, RN, CWOCN, CNS
Abstract:
Purpose: This inquiry explores the under-utilization of evidence-based skin care standing orders and attempts to address target etiologies to achieve the expected outcome of immediate, consistent treatment by the bedside RN. Significance: Over 1 million people develop pressure ulcers yearly with treatment costing the United States healthcare system approximately $2.2 to $3.6 billion (Ratliff & Bryant, 2003). Pressure ulcer prevalence is currently estimated at 3.5%-29.5% in hospitals on any given day (Hiser, et al., 2006). Pressure ulcers cause pain and suffering and can increase length of stay (Brem & Lyder, 2004). Many pressure ulcers can be prevented and treated utilizing nursing measures. Background/Design: Two clinical nurse specialists (CNS) developed a set of evidence-based nursing skin care standing orders to allow the registered nurse (RN) to treat non-disease based skin problems resulting from pressure, friction, shear and moisture. The expected outcome of a decrease in the amount of time from onset of the problem to treatment of the problem did not occur. Methods: A survey containing eight questions was given to a convenience sample of 20 RNs. The questions were designed to target the correct etiologies. The results revealed a perceived presence of expertise in the standing orders not seen in nursing practice. The survey results revealed multiple etiologies: 1. RNs are not aware of standing orders 2. RNs do not know how or what to write for standing orders 3. RNs do not have confidence in deciding upon dressings, distinguishing between pressure ulcers and non-pressure ulcers and accurately staging pressure ulcers. Findings: The expected outcome is to empower the bedside RN to diagnose and treat the skin care conditions listed on the standing orders. An additional outcome is to positively influence pressure ulcer rates by reducing delay in treatment time and promoting consistent prevention and treatment. Unexpected outcomes were designation of unit-based skin care champions, training for the champions, designation of the skin care standing orders into a nursing order set and development of pressure ulcer bundle indicators. Conclusions: Continuous mentoring must exist in terms of assistance with problem solving, analyzing the effectiveness of the orders and examining the salience of the problem to be successful in achieving desired outcomes. Implications for Practice: Prevention and treatment of stage I and II pressure ulcers are included in the skin care standing orders. Failure to utilize these orders could easily impact pressure ulcer rates. The mean cost per hospital admission for a patient who develops a pressure ulcer is $37, 288 (Ratliff & Bryant, 2003). The benefit of having expert RNs at the bedside trained and empowered to intervene at the point of care is to prevent costly, negative outcomes for both the patient and the organization.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
CNS Outcomes: Ensuring Safety and Quality
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Phoenix, Arizona, USA
Description:
Conference theme: CNS Outcomes: Ensuring Safety and Quality, held February 28-March 1 in Phoenix, Arizona, 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_US
dc.typePresentationen_GB
dc.titleEmpowering Nursing Autonomy with Skin Careen_GB
dc.contributor.authorJackson, Kathrynen_US
dc.contributor.authorMcCubbin, Lenaen_US
dc.author.detailsKathryn Jackson, RN, CNS, CRRN, Columbus Regional Hospital, Columbus, Indiana, USA, email: nacnsorg@nacns.org; Lena McCubbin, MS, RN, CWOCN, CNSen_US
dc.identifier.urihttp://hdl.handle.net/10755/164203-
dc.description.abstractPurpose: This inquiry explores the under-utilization of evidence-based skin care standing orders and attempts to address target etiologies to achieve the expected outcome of immediate, consistent treatment by the bedside RN. Significance: Over 1 million people develop pressure ulcers yearly with treatment costing the United States healthcare system approximately $2.2 to $3.6 billion (Ratliff & Bryant, 2003). Pressure ulcer prevalence is currently estimated at 3.5%-29.5% in hospitals on any given day (Hiser, et al., 2006). Pressure ulcers cause pain and suffering and can increase length of stay (Brem & Lyder, 2004). Many pressure ulcers can be prevented and treated utilizing nursing measures. Background/Design: Two clinical nurse specialists (CNS) developed a set of evidence-based nursing skin care standing orders to allow the registered nurse (RN) to treat non-disease based skin problems resulting from pressure, friction, shear and moisture. The expected outcome of a decrease in the amount of time from onset of the problem to treatment of the problem did not occur. Methods: A survey containing eight questions was given to a convenience sample of 20 RNs. The questions were designed to target the correct etiologies. The results revealed a perceived presence of expertise in the standing orders not seen in nursing practice. The survey results revealed multiple etiologies: 1. RNs are not aware of standing orders 2. RNs do not know how or what to write for standing orders 3. RNs do not have confidence in deciding upon dressings, distinguishing between pressure ulcers and non-pressure ulcers and accurately staging pressure ulcers. Findings: The expected outcome is to empower the bedside RN to diagnose and treat the skin care conditions listed on the standing orders. An additional outcome is to positively influence pressure ulcer rates by reducing delay in treatment time and promoting consistent prevention and treatment. Unexpected outcomes were designation of unit-based skin care champions, training for the champions, designation of the skin care standing orders into a nursing order set and development of pressure ulcer bundle indicators. Conclusions: Continuous mentoring must exist in terms of assistance with problem solving, analyzing the effectiveness of the orders and examining the salience of the problem to be successful in achieving desired outcomes. Implications for Practice: Prevention and treatment of stage I and II pressure ulcers are included in the skin care standing orders. Failure to utilize these orders could easily impact pressure ulcer rates. The mean cost per hospital admission for a patient who develops a pressure ulcer is $37, 288 (Ratliff & Bryant, 2003). The benefit of having expert RNs at the bedside trained and empowered to intervene at the point of care is to prevent costly, negative outcomes for both the patient and the organization.en_GB
dc.date.available2011-10-27T11:43:57Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:43:57Z-
dc.conference.date2007en_US
dc.conference.nameCNS Outcomes: Ensuring Safety and Qualityen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationPhoenix, Arizona, USAen_US
dc.descriptionConference theme: CNS Outcomes: Ensuring Safety and Quality, held February 28-March 1 in Phoenix, Arizona, USAen_US
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.en_US
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