Development and implementation of a skin care program.

The incidence of nosocomial pressure ulcers for the identified high-risk patient care areas totaled 21% of the 152 patients in the first skin audit. The incidence of nosocomial pressure ulcers for the second audit of 156 patients was 12%. The second skin audit was accomplished six months after the implementation of a skin care program that included assessment forms, general and unit based education of nursing staff, development and implementation of Standards of Care for Skin Care, and provision of skin care products on the nursing unit. The population characteristics of the total sample indicated a fairly even male-to-female ratio and the average age was 60 to 69 years for both audit populations. The mode for the first audit was age 70 to 79 and for the second was 60 to 69. Most of the sample experienced neurological and musculoskeletal problems that adversely affected the patients mobility. One-fourth of the first sample and 1/2 of the second audit sample were bedridden. One-fifth of both samples experienced incontinence and almost 1/3 of both samples used incontinence devices (Foleys and collectors).