FOURTEENTH ANNUAL EUROPEAN PRESSURE ULCER ...

Thursday September 1st
Proceedings of the 14th Annual European Pressure Ulcer Meeting
Oporto, Portugal
Skin the Greatest Organ. Back to the Essentials Using Millennium Technology.
Tracy Nowicki 1, Kerri Roosen 2, Paul Fulbrook 3
1, 2 The Prince Charles Hospital, Australia, Tracy_Nowicki@health.qld.gov.au
3 The Prince Charles Hospital, Australia PhD, MSc, PGDipEduc, BSc (Hons), Nursing Director, Research
and Practice Development
Introduction
Pressure injury prevention is a priority due to the
pain and discomfort for patients and the added
expense of additional resources and increased
length of stay in hospitals (1). In our hospital,
despite ongoing pressure injury management
including risk assessment, a base mattress
replacement program, and acquisition of a variety
of pressure relieving devices, pressure injury
prevalence increased from 7.55% in 2006 to
13.73% in 2008. Of the 75 pressure injuries
identified, 43 (57%) were stage one. To address
the increased prevalence we implemented a
pressure injury prevention project, with the aims
of improving practice to reflect evidence based
guidelines and standardising continence, skin
care, and nutrition management.
This clinical update is based upon the findings of
a recent clinical audit in our hospital. To
determine evidence based practice, we took a cue
from the latest pressure injury forums and
investigated further evidence to guide our
practice. The purpose of this update is use a
pragmatic approach to outline current best
practice with respect to continence, skin care and
nutrition management, and to highlight some of
the issues regarding customary practices.
Results
After implementing the actions described above,
our pressure injury prevalence has decreased from
13.78% in 2008 to 5.15% in 2010, which
represents a 62% reduction. Of these pressure
injuries, 53% were stage one.
Discussion
To prevent pressure injuries our experience
indicates the importance of focusing on three key
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areas of practice: continence, skin hygiene, and
nutrition. These are a synergistic trio, and many
patients require considered management in all
three areas. In addition to targeting specific
aspects of nursing care in these areas, it is also
crucial that there is organisational buy-in for
strategic initiatives. Some of the ways that we
achieved this are outlined below:
• Support from managerial level by presenting
evidence and education to senior nurses and
directors.
• Nurse unit managers completed individual
ward action plans outlining their individual
commitments to reducing pressure injuries.
• Providing support and education to staff to
choose and use continence products
effectively.
• Support from allied health colleagues in
prevention of pressure injuries.
• Standardizing skin care and continence
products
• Removing continence mats from mattresses
References
(1) Duncan, K.D. 2007. Preventing pressure
ulcers: the goal is zero. Joint Commission
Journal on Quality and Patient Safety.
33(10):605-610.
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