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Maintaining patients’ skin integrity reduces hospital-acquired infection rates and length of stay

Maintaining patients’ skin integrity reduces hospital-acquired infection rates and length of stay

Maintaining patients’ skin integrity reduces hospital-acquired infection rates and length of stay
QUESTION
Maintaining patients’ skin integrity reduces hospital-acquired infection rates and length of stay.

Respond in a single well-written paragraph.
Take the Pieper Pressure Ulcer Knowledge Test .
Compare your answers to the answer key
Provide your score and, in no more than one paragraph, develop three to five objectives to help you improve your knowledge of providing safe care to patients who may have skin integrity issues.
Maintaining patients’ skin integrity reduces hospital-acquired infection rates and length of stay

ANSWER
Skin integrity is an important component of infection prevention, with pressure injuries and wound-related complications posing a significant risk to patient outcomes.

The University of Chicago Medicine’s successful “Countdown to Zero” skin integrity program received the sixth annual 3M Award for Excellence in Skin Safety in May, according to 3M and the Wound, Ostomy, and Continence Nurses Society. The program was recognized for reducing the number of preventable skin injuries within the academic medical center, including an 83 percent reduction in pressure injuries.

The majority of acute-care institutions are aware of their hospital-acquired pressure injury rate as part of their overall patient skin integrity monitoring, according to Susan Solmos, MSN, RN, CWCN, manager of nursing clinical services at University of Chicago Medicine. “Most hospitals track hospital acquired pressure injury (HAPI) rates, especially since the CMS implemented reimbursement penalties in 2008.”

The Countdown to Zero program was launched in 2014, following an examination of nursing practices and available products to identify factors contributing to the system’s higher-than-average hospital-acquired pressure injury rate. To help reduce the point prevalence of pressure injuries, incontinence-associated dermatitis (IAD), intertriginous dermatitis (ITD), and friction injuries, a monthly auditing program was established.

According to pre-program analysis, some clinicians were unable to differentiate between certain types of skin injuries, which could lead to incorrect treatment. As a result, clinician education became a key component of the Countdown to Zero program.

“Nursing practice continues to evolve, including the staging and differentiation of pressure injuries versus other common skin injuries,” says Sol-mos. “Experts must incorporate new knowledge into their practice and determine while also disseminating to frontline nursing staff.”

At the University of Chicago Medicine, an intensive yet accessible education program was developed, providing learning opportunities about skin injuries in a variety of formats, including new hire orientation, computer-based programs, formal 30-minute in-services, and informal five-minute in-services conducted right at the bedside. The medical center has seen a decrease in all targeted preventable skin injuries since the program’s implementation.

Ongoing, regular clinician education is critical to good patient outcomes, and as Solmos emphasizes, “it is necessary to provide knowledge in a format that nurses can immediately use, such as soundbites, in order to integrate new knowledge into practice.” Following this, practice prompts and efforts to ensure new knowledge is integrated into practice can be implemented.”

Solmos attributes the program’s success to “expert identification of knowledge, practice, and product gaps” as a cornerstone. “Data analysis of monthly prevalence studies and direct observation of practice are used to determine where improvement is needed on a continuous basis,” she says. “Unit-based champions (RNs and NSAs) reinforce reminders and prompts to integrate and reinfuse knowledge and/or practice.” The expert’s percentage effort in sustaining and improving practice was equal to or greater than the percentage effort in implementing the program.” “Through the hard work of our skin-care team, our preventable skin injury rates continue to improve year over year,” she adds. In fact, we recently achieved our ultimate goal of recording zero instances of Stage 2 and above pressure injuries in all patients surveyed, including critically ill adult and pediatric patients, which is incredible. We have been able to improve our system-wide standard of care in a very tangible way for our patients by prioritizing skin integrity education and continuous evaluation.”

“Pressure injuries can lead to serious consequences such as osteomyletis, sepsis, and septic shock; therefore, prevention is a priority,” Solmos says.

“Products should be critically evaluated to determine if their performance meets the needs of the patient population and program,” Solmos says of evaluating skin integrity-related products. Products should also be evaluated to see if they are intended to reduce the risk of pressure injuries caused by medical devices.”

The award was made possible through a collaboration between the WOCN Society and 3M, with the goal of recognizing the most innovative and inspiring individuals or healthcare facilities that have implemented a program to improve patient skin integrity and skin health.

“UChicago Medicine and its dedicated staff are truly at the forefront of prioritizing, implementing, and sustaining skin injury prevention,” says 3M vice president of global marketing Leslie McDonnell. “Each year, it’s an honor to learn about and recognize outstanding facilities, such as UChicago Medicine, that truly understand the importance of skin integrity in patient care.”

To win, the program must show measurable and sustained results from prevention, senior leadership engagement, product formulation, and interdisciplinary participation.

“Through this award program partnership with 3M, we are reminded on a regular basis of the exceedingly profound contributions made by nurses dedicated to pressure injury prevention, because it is not an easy task,” says Carolyn Watts, MSN, RN, CWON, president of the WOCN Society. “We have no doubt that other medical facilities are making significant strides toward skin integrity, as we received a record number of award submissions this year.” UChicago Medicine stood out for its exceptional fulfillment of each requirement, going above and beyond each year of the program, and we congratulate their team.”

Maintaining patients’ skin integrity reduces hospital-acquired infection rates and length of stay

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