The VCU Pressure Ulcer Summit—Developing Centers of Pressure Ulcer Prevention Excellence

Abstract

Hospital-acquired pressure ulcer occurrences have declined over the past decade as reimbursement policies have changed, evidence-based practice guidelines have been implemented, and quality improvement initiatives have been launched. However, the 2006-2008 Institute for Healthcare Improvement goal of zero pressure ulcers remains difficult to achieve and even more challenging to sustain. Magnet hospitals tend to have lower hospital-acquired pressure ulcer rates than non-Magnet hospitals, yet many non-Magnet hospitals also have robust pressure ulcer prevention programs. Successful programs share commonalities in structure, processes, and outcomes. A national summit of 55 pressure ulcer experts was convened at the Virginia Commonwealth University Medical Center in March 2014. The group was divided into 3 focus groups; each was assigned a task to develop a framework describing components of a proposed Magnet-designated Center of Pressure Ulcer Prevention Excellence. Systematic literature reviews, analysis of exemplars, and nominal group process techniques were used to create the framework. This article presents a framework describing the proposed Magnet-designated Centers of Pressure Ulcer Prevention Excellence. Critical attributes of Centers of Excellence are identified and organized according to the 4 domains of the ANCC model for the Magnet Recognition Program: transformational leadership; structural empowerment; exemplary professional practice; and new knowledge innovation and improvements. The structures, processes, and outcome measures necessary to become a proposed Center of Pressure Ulcer Prevention Excellence are discussed.

Construção e confiabilidade interna de um algoritmo para escolha da limpeza e terapia tópica em feridas

“…10,[12][13][16][17][18][19][20] The nurse is the best qualified professional to lead programs for the prevention and treatment of patients with injuries because they spend part of their time with the patient, evaluating the skin changes that influence the risk of development and evolution of wounds, besides managing the care. [21][22] The practice of caring for people with wounds is a specialty within nursing, recognized by SOBENDE and SOBEST. It is a challenge that requires specific knowledge, skills and holistic approach, as well as the search for up-to-date information and new care strategies.…”

Preventing pressure injuries in the emergency department: Current evidence and practice considerations

“…In addition, it is important that the ED management team be supportive of an ED‐based initiative and practice change to provide PI prevention. Without this mid‐level support, unit‐based programmes often lack success . In addition to management support for PI prevention, the hospital's overarching mission, vision, and values typically creates the basis for the local culture that underpins the type and quality of care delivered on individual units.…”

“…They directly provide the necessary peer‐to‐peer influence, holding one another accountable for practice changes. In addition, they can collect and report data, assist with education and competencies, and create ways to celebrate successful outcomes …”

“…Without this mid-level support, unit-based programmes often lack success. 49 In addition to management support for PI prevention, the hospital's overarching mission, vision, and values typically creates the basis for the local culture that underpins the type and quality of care delivered on individual units. When a change in practice is required, this process is successfully accomplished when the change agent takes into consideration the specific unit's culture.…”

“…In addition, they can collect and report data, assist with education and competencies, and create ways to celebrate successful outcomes. 49 The successful implementation of contemporary PI prevention strategies in the ED may require not only education of all ED staff on the ED incidence rates and pathogenesis of PI but also the evidence of which patients are at greatest risk, recommended preventative interventions, and the need for ongoing monitoring. 50 Similarly, the ED staff bears the responsibility of understanding the positive or negative impact their care has on an admitted patients' skin integrity.…”