IngentaConnect Eliminating Facility-Acquired Pressure Ulcers at Ascension Health

Authors: Gibbons, Wanda; Shanks, Helana T.; Kleinhelter, Pam; Jones, Polly

Source: Joint Commission Journal on Quality and Patient Safety, Volume 32, Number 9, September 2006 , pp. 488-496(9)

Publisher: Joint Commission Resources

Abstract:

Background: In 2004, as part of Ascension Health's "Healthcare That Is Safe" initiative, St. Vincent's Medical Center, as an alpha site, was charged with defining best practices to eliminate facility-acquired pressure ulcers. A comprehensive plan, including the "SKIN" (Surfaces, Keep the patients turning, Incontinence management, Nutrition) bundle, was developed.

Results: The incidence of pressure ulcers decreased from > 2% to < 1% from December 2004 through February 2006. No new Stage III or IV facility-acquired pressure ulcers occurred between August 2004 and February 2006. Weekly SKIN operations meetings and use of the SKIN process tool ensured that all at-risk patients were receiving appropriate interventions.

Reporting and Spread: The alpha site work and SKIN bundle were presented to all 67 Ascension Health acute care facilities at a rapid-design-format Pressure Ulcer Summit in mid 2005. All acute care facilities agreed to a single model of care using the SKIN bundle and common measures of quality and performance.

Discussion: The St. Vincent's alpha site initiative in pressure ulcer prevention, enabled it to identify at-risk populations, implement appropriate actions, and achieve positive, measurable, meaningful results.

Conclusion: The SKIN program was adopted and is being implemented throughout Ascension Health.

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