| Primary Author: | Jayne O’Leary, RN, MSN |
| Organization: | North Shore Long Island Jewish HS |
Abstract
Background
In October 2008, the Center for Medicaid and Medicare Services (CMS), launched a new Medicare payment provision through which 11 hospital-acquired conditions may result in decreased reimbursement if not coded as “Present on Admission”(POA).
Purpose
Our pressure ulcer taskforce was charged with developing a toolkit and resources that standardized our practices, guidelines, and policies based on evidence based practice.
Materials & Methods
The National Data base of Nursing Quality Indicators (NDNQI) was implemented as the basic competency for all nursing staff at hire and annually. Standardized formulary, protocols and guidelines for assessment and treatment were developed and placed on all nursing units. The toolkit was developed and placed on our intranet site as a resource and adjunct to our policy on pressure ulcers.
Every hospital created a team of RN and PCA/NA skin care expert’s. Data collection tools, a webcast and internal reporting were formalized by our professional practice group with collaboration with our experts at quality. Best practices on skin care documentation, staging and care were videotaped and added to our skin care portal for staff to access and utilize for contact hours if desired.
Results
Expert skin care teams were created in each site. Rounding with the team and observing the staff perform skin care demonstrated the hardwiring of the program. The Wound, ostomy and continence nurses (WOCN’s) facilitated training at the sites that do not have certified skin care specialists. As of December 2010, Pressure ulcer index is slightly above our target goal.
Conclusion
Research suggests that the focus on pressure ulcer prevention must be hospital- wide and focused on all patient care providers. The hiring of additional WOCN’s will ensure the development of expert high performing teams and improved outcomes.
Bibliography
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© Improvement Science Research Network, 2011