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A multidisciplinary team consisting of nurses, physicians, and wound care specialists came together in an effort to decrease the rate of PUs The goal was to reduce HAPUs by 25% within a six-month period after initiation of the performance improvement (PI) plan.
The manifestation of hospital-acquired pressure ulcers is of great concern in organizations today The loss of reimbursement to treat HAPUs is causing facilities to initiate PI plans and EBP guidelines to prevent PUs.
This study modeled the predictive power of measures representing patient characteristics, nurse workload, nurse expertise, and HAPU preventive clinical processes of care on HAPU prevalence.
Four sets of unit-level predictor variables were studied: unit/patient characteristics, nurse workload, RN expertise, and HAPU clinical processes of care.
Clinical process variables related to HAPU were obtained from direct observation and chart review computed as percentages of all patients included in the study.
Outcome measures were prevalence of HAPU at any stage (stages I-IV, unstageable, and deep tissue injury [DTI]) and HAPU stage II or greater (stages II-IV and unstageable, without DTI).
Summary statistics for the HAPU outcome variables and model covariates were examined.
The taskforce created a HAPU prevention program with the following components:
HAPU prevention guidelines addressing unit-specific issues, such as hip fracture patients, devices, and adequate pain control.
Educating charge RNs of their responsibilities in ensuring HAPU prevention.
The first action item involved creating Individualized Action Plans (see Table I), which outlined the steps of the HAPU prevention program and were signed by all staff.
The unit-specific HAPU Prevention Guidelines (see Table 2) were developed combining evidence-based practice and hospital guidelines to address the issues identified by the HAPU taskforce (Evans, Barklam, Hone, Ellis, & Whitlock, 2013).
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