Transforming pediatric pressure injury outcomes using a ...
1
Rebekah Barrette, MS, RN, PCNS-BC, WCC Children’s Hospital of Wisconsin, Milwaukee, WI Action Taken • A Pressure Ulcer Prevention (PUP) program was developed by the CNS o Nurse skin champion model used to improve outcomes. • Model initiated on all inpatient units • To address the needs of patients & nurses • To ↓ the number of hospital acquired pressure injuries Background • Hospitalized children have increased in complexity & volume resulting in o ↑ risk for skin breakdown o concomitant ↑ in pressure injuries • An innovative approach using the clinical nurse specialist (CNS) was developed to manage the challenging problem. Results • 80% improvement in compliance for all bundle elements hospital wide since initiation of program • Over 12 months – 25% ↓ o Deep tissue injury o Stage 3, 4, & unstageable pressure injuries • Cost savings estimated ~$100,000 for one year. Pressure Injury Prevention Bundle Elements • Daily Full Skin Assessment • Device Rotation • Appropriate Bed Surface • Moisture Management • Repositioning Actions • Skin champions focus on o Specific interventions for risk areas – mobility/activity, moisture, & friction o Adherence to the 5 pressure injury bundle elements • Standardized care plans o Patient individualized Stage 1 & 2 pressure injuries Diaper dermatitis • Specific skin champion strategies include: o Skin assessments with bedside RNs o Weekly staff rounding o Peer evaluation of documentation o Bedside huddles o Patient care plan review • Leadership o Wound and Skin CNS – Monthly meeting o Quality and Patient Safety Department – data support Acknowledgements Thank you to Eileen Sherburne, Christine Schindler, the PUP team, and the Quality and Patient Safety Department for their continued work and support. Transforming pediatric pressure injury outcomes using a skin champion model program and clinical nurse specialist leadership 0% 20% 40% 60% 80% 100% Bundle Compliance Pressure Ulcer Bundle Compliance Key Steps/Takeaways • CNS Leadership supports & enhances staff RN – RN collaboration & practice • Unit skin champion model promotes sustainability of evidence-based interventions. o ↑ in nursing knowledge o Transformation of nursing practice o ↓ risk for pressure injuries o Improved outcomes
Transcript of Transforming pediatric pressure injury outcomes using a ...
Rebekah Barrette, MS, RN, PCNS-BC, WCC
Children’s Hospital of Wisconsin, Milwaukee, WI
Action Taken
• A Pressure Ulcer Prevention (PUP) program was developed by the CNS o Nurse skin champion model used to
improve outcomes. • Model initiated on all inpatient units
• To address the needs of patients & nurses
• To ↓ the number of hospital acquired pressure injuries
Background
• Hospitalized children have increased in complexity & volume resulting in o ↑ risk for skin breakdown o concomitant ↑ in pressure injuries
• An innovative approach using the clinical nurse specialist (CNS) was developed to manage the challenging problem.
Results
• 80% improvement in compliance for all bundle elements hospital wide since initiation of program
• Over 12 months – 25% ↓ o Deep tissue injury o Stage 3, 4, & unstageable pressure
injuries
• Cost savings estimated ~$100,000 for one year.
Pressure Injury Prevention Bundle Elements
• Daily Full Skin Assessment • Device Rotation • Appropriate Bed Surface • Moisture Management • Repositioning
Actions
• Skin champions focus on o Specific interventions for risk areas –
mobility/activity, moisture, & friction o Adherence to the 5 pressure injury
bundle elements • Standardized care plans
o Patient individualized Stage 1 & 2 pressure injuries Diaper dermatitis
• Specific skin champion strategies include: o Skin assessments with bedside RNs o Weekly staff rounding o Peer evaluation of documentation o Bedside huddles o Patient care plan review
• Leadership o Wound and Skin CNS – Monthly
meeting o Quality and Patient Safety
Department – data support
Acknowledgements Thank you to Eileen Sherburne, Christine Schindler, the PUP team, and the Quality and Patient Safety Department for their continued work and support.
Transforming pediatric pressure injury outcomes using a skin champion model program and clinical nurse specialist leadership
0%
20%
40%
60%
80%
100%
Bu
nd
le C
om
plia
nc
e
Pressure Ulcer Bundle Compliance
Key Steps/Takeaways
• CNS Leadership supports & enhances staff RN – RN collaboration & practice
• Unit skin champion model promotes sustainability of evidence-based interventions. o ↑ in nursing knowledge o Transformation of nursing practice o ↓ risk for pressure injuries o Improved outcomes
