Title : Pressure injury/skin tear program
Abstract:
A Wound Prevalence Survey was completed in 2013 in partnership with Convatec Canada in Western Newfoundland and it identified a need for the implementation of a program for early detection and appropriate treatment of pressure injuries and skin tears. It was also noted there was a need for a standardized wound product formulary. A Pressure Injury and Skin Tear Prevention Program was developed since 2013. The program involved education sessions on pressure injury and skin tear prevention and management. In addition, wound management products were standardized. Furthermore, three e-learning modules on Pressure Injury Prevention, Braden Scale and Wound Healing & Nutrition have been added to the Western Health E-Learning system. Electronic online documentation and policies cover Braden Scale, Skin Assessment, Wound Assessment, Dressing Intervention, Negative Pressure, Wound Culture, Falls Prevention, Hydration Program and Therapeutic Support Surfaces. A recent Braden Scale Audit showed that regional completion rates ranged from 98%-100%. The Therapeutic Support Surface policy was built into the electronic system which involves a mattress tracking system to ensure appropriate surfaces are available to patients/residents for preventing pressure injuries. A pamphlet for patients and caregivers titled Pressure Ulcer Prevention-Tips for Caregivers was developed. A Wound Management Quick Reference Pocket Guide was developed to assist nurses to make wound-related decisions at the point when care is being organized or provided. The guide provides an overview of 12 commonly encountered, but not well understood, wound care topics including fundamentals of wound management, assessment, and infection, different type of ulcers such as pressure injuries, other conditions including incontinence associated dermatitis, skin tears, wound management products, and debridement. A Wound Resource Nurse Education Program started 2015 which involves an annual two day event that is attended by the same 80 Registered Nurses with representation from the entire region covering long term care, acute care and community. These Wound Care Resource Nurses have received advanced training in effective wound prevention and management therefore they are an extra resource for wound care advice throughout the region. There is a new wound management and skin care product list that is standardized for the region. This list helps standardize wound and skin care products to ensure that clients, patients and residents get the best possible care in the most financially responsible way. In 2018, the prevalence survey showed the appropriate use of wound management products in all areas with proper dressing change frequency. There has been significant decrease in preventable wounds and an increase in the utilization of wound and skin care best practice recommendations. In the latest prevalence survey the rate for pressure injuries in LTC was 8.7% compared to the prevalence rate from 2013 which was 10.3% and in Acute Care it was down to 10.1% compared to the prevalence rate from 2013 which was 12.9%. Also the rate of skin tears in Long Term Care was 0.4 % compared to the prevalence rate from 2013 which was 14.0% and in Acute Care it was 3.3 % compared to the prevalence rate from 2013 which was 12.5%.
This presentation will benefit the audience as it provides key points, guidelines and explanations of how to implement a pressure injury and skin tear program within their health authority. Other facilities could use prevalence surveys to obtain baseline data on specific wounds to help identify wound and skin care needs in their organization. From our original prevalence survey, our organization targeted pressure injuries and skin tear prevention/management as a key priority. There are practical steps involving the creation of policies, electronic documentation and tracking, educational resources and programs, such as wound care resource nurse training sessions that have been valuable to increasing the overall quality of wound care management within our region.
