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by Ashley Barker
Public Relations
A group of 100
nurses and patient care technicians at
MUSC known as the SKIN team is launching
an initiative to prevent pressure
ulcers, commonly referred to as
bedsores.
 Members of the
SKIN team meet to discuss an initiative
to prevent pressure ulcers, known as
bedsores.
During the past year, the team has
worked to reduce the number of
hospital-acquired adult pressure ulcer
cases from 16 percent in the first
quarter of 2012 to 13 percent in the
second quarter, 8 percent in the third
quarter and 3.3 percent in the fourth
quarter, according to data compiled from
surveys by the National Database of
Nursing Quality Indicators (NDNQI).
A pressure ulcer is an injury to the
skin and underlying tissue usually
caused by constant pressure. A report
from the U.S. Department of Health &
Human Services said 2.5 million patients
per year are affected by pressure ulcers
and about 60,000 of those patients die
as a direct result. In 2007, Medicare
estimated that each pressure ulcer added
an average of $43,180 to the cost of a
hospital stay.
One of the goals of the SKIN (surface,
keep moving, incontinence and nutrition)
team is to educate staff members about
risk identification, staging, and
prevention of pressure ulcers. The SKIN
bundle that is being introduced by the
team is an effort to assure best
practices become standard at MUSC. The
bundle includes the following
guidelines:
- A
comprehensive skin and risk assessment
should be completed on all patients at
admission and each shift.
- Surface:
Patients should be on the optimal
surface to meet their needs and manage
pressure. Appropriate mattresses,
beds, cushions and heel off-loading
devices should be in use.
- Keep moving:
Patient mobility should be encouraged
with appropriate therapy modalities
initiated early — repositioning
patients and encouraging out-of-bed
status when appropriate.
- Incontinence:
Prompt attention to incontinence, use
of incontinence products, toileting
assistance and proper moisture
management should be the standard of
practice.
- Nutrition:
Assess and address nutrition and
hydration needs on admission and each
shift for all patients. Consult
nutrition services when appropriate
and provide supplementation as needed.
In addition to the SKIN
bundle, patients who already have or are
at risk of developing pressure ulcers will
be easily identified. A blue iceberg
symbol encased in a black circle will be
on patient wrist bands and on the front of
charts. The iceberg symbolizes that
although there is visible damage on the
surface, what is below may be more
serious.
Pressure ulcers, which
commonly occur in the posterior pelvic
region and the heel or ankle region, are
associated with a longer length of
hospital stay, sepsis, increased pain and
suffering, and mortality, according to
Phill Botham, R.N., Department of
Specialty Nursing.
"Great progress has
been noted in reducing our pressure ulcer
incidence over the past year, and a
dedicated group of professionals from the
bedside, ER, OR, dialysis and ancillary
areas of the hospital are working hard to
change the culture here at MUSC," he
stated. "In MUSC's drive toward changing
what is possible, we are committed to
eliminating all avoidable pressure
ulcers."
Friday, Feb.
8, 2013
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