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How to reduce hospital-acquired pressure ulcers on a neuroscience unit with a skin and wound assessment team.
MedLine Citation:
PMID:  23230519     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In 2008, the incidence of hospital acquired pressure ulcers (HAPUs) continued to increase on a neuroscience unit that included both neurosurgical and neurological patients in a 14-bed intensive care unit, and in a 18-bed floor unit.
METHODS: To reduce HAPUs, several changes were instituted in 2008; (1) turning patients every 1-2 h/repositioning, (2) specialty beds, and (3) a "skin and wound assessment team (SWAT)" that included one (or two) "expert" nurses/nursing assistants who made rounds on all the patients in the unit at least once a week. They would examine patients from "head to toe", document/measure all pressure ulcers, and educate primary nurses/nurse assistants on the plan/products needed for the patients wound care based on their assessments. In 2010, further measures included: (1) adding eight Stryker beds, (2) adding pressure relieving heel protector boots, and (3) requiring that all new hospital orientees work one shift (7.5 h) shadowing the SWAT team.
RESULTS: The SWAT team initially decreased HAPUs by 48% in 2009; this reduction was further increased in 2010 (57%), and 2011 (61%). Additionally, in 2010, the SWAT team was required to educate nurses in all other units. By 2011, all nurses had to complete the hospital acquired pressure ulcer prevention tutorial.
CONCLUSIONS: Since instituting a specialized SWAT team for our neuroscience unit, the incidence of HAPUs (cost estimated for grade IV, US $129,248) was decreased by 48% in 2009, by 57% in 2010, and by 61% in 2011. The SWAT program is now hospital-wide.
Authors:
Janice McGuinness; Sherry Persaud-Roberts; Susan Marra; Jeannine Ramos; Diane Toscano; Linda Policastro; Nancy E Epstein
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Publication Detail:
Type:  Journal Article     Date:  2012-11-20
Journal Detail:
Title:  Surgical neurology international     Volume:  3     ISSN:  2152-7806     ISO Abbreviation:  Surg Neurol Int     Publication Date:  2012  
Date Detail:
Created Date:  2012-12-11     Completed Date:  2012-12-12     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  101535836     Medline TA:  Surg Neurol Int     Country:  India    
Other Details:
Languages:  eng     Pagination:  138     Citation Subset:  -    
Affiliation:
Neuroscience Unit, Winthrop University Hospital, Mineola, NY, USA.
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