Warner Julia, Ann Raible Mary, Hajduk Gina, Collavo Jacqueline
West Penn Hospital, part of Allegheny Health Network, Pittsburgh, Pennsylvania.
Crit Care Nurs Q. 2017 Jan/Mar;40(1):41-48. doi: 10.1097/CNQ.0000000000000140.
The State of Pennsylvania Hospital Engagement Network, in collaboration with a hospital system in Southwestern Pennsylvania, established a goal of reducing hospital-acquired pressure ulcers by 20%. A 6-month unfavorable trend of nurse-sensitive clinical indicators called for immediate process improvement. A retrospective chart review resulted in identification of predominant risk factors placing the burn patient at high risk for pressure ulcer formation. Implementations of pressure ulcer prevention measures were inconsistent. Nurses demonstrated varied levels of knowledge about products used for prevention. It became imperative to examine processes within the unit and provide nursing with education, access to skin care supplies, and advanced skin/wound care products for maintaining skin integrity. Creation of evidence-based guidelines was necessary to improve patient outcomes. A collaborative team approach influenced nursing and physician awareness of pressure ulcer risk. Evidence-based prevention guidelines were developed, and consistency in early intervention was achieved, supporting our culture of safety. A change in interprofessional collaborative practice and positive trend in pressure ulcer incidence data supports the success of our program.
宾夕法尼亚州医院参与网络与宾夕法尼亚西南部的一个医院系统合作，设定了将医院获得性压疮减少20%的目标。护士敏感临床指标连续6个月呈不利趋势，这就需要立即改进流程。一项回顾性病历审查确定了导致烧伤患者发生压疮的主要危险因素。压疮预防措施的实施并不一致。护士对用于预防的产品的了解程度各不相同。必须检查病房内的流程，并为护理人员提供教育、皮肤护理用品以及先进的皮肤/伤口护理产品，以维持皮肤完整性。制定基于证据的指南对于改善患者预后很有必要。采用协作团队方法提高了护理人员和医生对压疮风险的认识。制定了基于证据的预防指南，并在早期干预方面实现了一致性，这支持了我们的安全文化。跨专业协作实践的改变以及压疮发生率数据的积极趋势证明了我们项目的成功。
