At West Penn Hospital (WPH), a part of Allegheny Health Network, nurses are leading innovative quality care initiatives to push the hospital’s pressure ulcer rate even farther below the national average.
The Pennsylvania Hospital Engagement Network (PA-HEN) goal is reducing hospital-acquired pressure ulcers by 20%. “WPH’s rates are already below the national average, so further reduction is a special challenge,” notes Jacqueline Collavo, MA, BSN, RN, NE-BC, Director of Nursing Operations and the Magnet Recognition Program® at WPH.
“But as the region’s first facility designated a Magnet® hospital for nursing excellence by the American Nurses Credentialing Center, we’ve embraced the opportunity to continue to meet challenges and remain focused on quality as we journey toward our third Magnet® designation.”
To lead the challenge, Collavo brought Enterostomal Therapist Julia Warner, BSN, RN, CWON, on board in October 2012. Warner quickly partnered with nursing and other disciplines to develop evidence-based best-practice programs for pressure ulcer reduction, patient safety and quality care.
“Camp Zero” education for nursing assistants
Warner’s “Camp Zero” program (after the PA-HEN’s “Chasing Zero”) increases nursing assistants’ awareness of pressure ulcer prevention, educates them about ulcers and prevention, and engages and empowers them as integral members of the prevention team.
All WPH NAs completed Camp Zero training (average post-test scores: 90.0%) in 2013 and raved about the experience. The program has garnered wide recognition – Warner presented a webinar to 125 nurses from 24 organizations across Pennsylvania on March 20 and will make her first national presentation in June.
“Turning Up the Heat” in the burn unit
A first-quarter 2013 up-tick in pressure ulcer incidence on WPH’s Burn Unit led Warner and the unit’s nurses to “turn up the heat” on ulcer prevention.
Unit Coordinator Kathleen Elliott, RN, conducted a retrospective chart review and in collaboration with burn surgeons, Warner and unit nurses identified patient risk factors and assessed healthcare providers’ current knowledge and use of prevention and treatment practices and products.
Armed with these findings, the nurses developed evidence-based best-practice skin care guidelines and gained access to advanced skin/wound care products. Tom Culley, BSN, RN, MBA, educated all members of the interdisciplinary team. The quick interventions brought the next quarter’s pressure ulcer count back to the unit’s typical “zero”.
“What Would ‘Flo’ Do?” in the stepdown unit
WPH’s E7 Progressive Care Unit Manager Maria Buchko, MSN, RN, and Clinical Nurse II Kimberly McLaughlin, RN, advocated for the purchase of a pump-equipped air mattress – an innovative “pressure redistribution support surface” – for each of the newly opened unit’s beds.
Due to acute health conditions and decreased mobility, this unit’s patients are at particular risk for pressure ulcers. With the special mattresses, bedside nurses can intervene immediately if they identify a skin issue simply by attaching the pump and pushing a button to start air flowing in the pressure redistribution system. Using the pumps, nurses have kept their unit’s pressure ulcer rate at zero – validating Buchko and McLaughlin’s prediction that the higher cost of the mattresses will be offset by superior quality outcomes.