• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
Michelle Tuck, Alfred Health - Early Identification of Patients at Risk of a Pressure Injury
 

Michelle Tuck, Alfred Health - Early Identification of Patients at Risk of a Pressure Injury

on

  • 206 views

Michelle Tuck, Clinical Nurse Consultant, Wound Management, Alfred Health delivered the presentation at 2013 Reducing Avoidable Pressure Injuries Conference. ...

Michelle Tuck, Clinical Nurse Consultant, Wound Management, Alfred Health delivered the presentation at 2013 Reducing Avoidable Pressure Injuries Conference.

The 2013 Reducing Avoidable Pressure Injuries Conference featured a comprehensive case study led program covering topics such as prevention of pressure injuries during the surgical patient journey and in people with Spinal Cord Injuries, meeting Standard 8, translating research into clinical practice and more.

For more information about the event, please visit: http://www.informa.com.au/pressureinjuries13

Statistics

Views

Total Views
206
Views on SlideShare
206
Embed Views
0

Actions

Likes
0
Downloads
2
Comments
0

0 Embeds 0

No embeds

Accessibility

Categories

Upload Details

Uploaded via as Adobe PDF

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    Michelle Tuck, Alfred Health - Early Identification of Patients at Risk of a Pressure Injury Michelle Tuck, Alfred Health - Early Identification of Patients at Risk of a Pressure Injury Presentation Transcript

    • Early Identification of Patients at Risk of a Pressure Injury Michelle Tuck Clinical Nurse Consultant- Wound Management
    • Session focus • Implementation of a pressure injury prevention round • Introduction of a skin assessment tool • Completion of pressure injury prevention plans based on risk assessment
    • We have good processes for management of pressure injuries… …but how do we put the focus on prevention?
    • Alfred Health The Alfred Hospital, Caulfield Hospital and Sandringham Hospital – Acute and mental health services, rehabilitation, aged care, residential care and community services, Women’s and Children’s Health. – Specialist services for trauma, emergency, intensive care • The Alfred is the state wide service for heart and lung replacement and transplantation, cystic fibrosis, burns, HIV/AIDS, haemophilia, sexual health, hyperbaric medicine.
    • Point Prevalence (time-series) - Alfred Health 30.7 26.8 20.3 16.2 17.0 16.6 14.8 11.0 10.7 13.2 0 5 10 15 20 25 30 35 2003 2004 2006 2007 2008 2009 2010 2011 2012 2013 Prevalence(%) Data including pressure injuries present on admission and hospital acquired
    • Trauma ward The 2009 point prevalence was higher than any other area in Alfred Health including ICU 2 West PUPPS Results 37% 38% 47% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 2007 2008 2009 Year PointPrevalence
    • Aims and Objectives • To provide focus on prevention of pressure injuries rather than the management of pre-existing injuries • Reduce the ward pressure injury point prevalence • Increase staff awareness regarding pressure injury prevention strategies • Improve documentation of pressure prevention plans
    • Methodology Run a weekly multidisciplinary pressure injury prevention round. The multidisciplinary team consists of : CNC- Wound Management, 2 West CS&DN/CNM, Podiatry, Nutrition, Manager of Inpatient Medical Equipment and Occupational Therapy.
    • Methodology Discussion at the bedside: • The patient’s pressure injury risk factors and current skin integrity • Current implemented pressure injury prevention strategies • Additional pressure injury prevention strategies Where appropriate patients are encouraged to participate
    • Performance Indicator • Monitor documentation of pressure injury prevention plans through quarterly audits • Future PUPPS results
    • Baseline Data • Previous PUPPS results • 2W PIP Audit Results ‘Appropriate plan identified’: Feb 2009 – 50% June 2009 – 40% October 2009 – 20%
    • Outcomes 2 West PIP Audit results Appropriate plan documented Feb 2010 – 50% August 2010 – 40%
    • 2 West PUPPS Results 10.53% 7.70% 11.63% 37% 38% 47% 28% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 2007 2008 2009 2010 2011 2012 2013 Year PointPrevalence
    • Considerations for the future • A weekly summary sheet was developed following several trials. • The tool is recommended for tracking weekly data.
    • Date / / Patient Nurse Is the Braden Score current ? Y/N Risk level (H/M/L) Are the appropriate allied health members involved? Y/N Does the patient have pressure injuries? Record location and stage Is there a PIP plan documented in the past 5 days? Y/N Are the current strategies in place appropriate and implemented ? Recommendations made by the round FOLLOW -UP Was the PIP plan written up? FOLLOW- UP Were the recomme nded interventi ons implemen ted? 2W PIP Round
    • Sustainability and Recommendations •The resource nurse/ACN on the shift is encouraged to lead the round. •Capture and document recommendations •Clarify who is to follow up post round •Review of weekly summary sheet •All staff to be involved at the commencement of each round
    • PUPPS Results at the Alfred 0 5 10 15 20 25 30 A B C D E F G H I J K L M N O Alfred Hlth Ward Prevalence(%) 2010 2011 2012 2013
    • Introduction of a skin assessment tool and completion of pressure injury prevention plans based on risk assessment
    • Pressure Injury Prevention/ Management Guideline Requirement All Patients Low Risk Patients Moderate-High Risk Patients Skin Assessment <8 hours of admission Daily Once per shift Pressure Injury Risk Assessment <8 hours of admission Daily Daily ICU – Once per shift ICU – Once per shift Documented Pressure Injury Prevention Plan <24 hours of admission At least every 5 days and following significant change in patient’s condition At least every 5 days and following significant change in patient’s condition Document effectiveness of interventions in Inpatient Progress Notes At least daily At least daily At least daily
    • Pressure injury risk assessment A 3 step process 1. Assess your patient’s skin 2. Assess your patient’s pressure injury risk The Braden Scale for Predicting Pressure Sore Risk 3. Document a Pressure Injury Plan
    • Skin Assessment • Skin Assessment • Daily or once per shift depending on Braden • Within 8 hours of admission
    • Braden Risk Assessment
    • Pressure Injury Prevention Plan Mandatory for all patients
    • Determine plan according to patient’s risk factors for all moderate to high risk patients and initial and date the appropriate strategies Observe bedside to ensure strategies are implemented Staff sign patient involved in discussion
    • Resources Pressure Injury Staging Braden Definition of Rating Scale
    • Prevention is the Key! Nutrition Sheer Friction Comfy Ears Moisture Mobility – Turning surfaces
    • Thank you • Any questions? Together we can all make a difference to prevent pressure injuries!