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An Indiana initiative to reduce pressure ulcers throughout all areas of health care has resulted in a reduction of bedsores at more than 160 organizations participating in the project.
With pressure ulcers representing the most commonly reported medical error since Indiana started mandatory reporting in 2006, it made sense to look for ways to increase the identification of the risk of pressure ulcers and improve methods of preventing pressure ulcers, say project participants. A key component of the Indiana Pressure Ulcer Initiative's collaboration between health care providers, which was launched in June 2008 and concluded in August 2009, was the focus on a pressure ulcer risk assessment at admission. At the project's start, only 42.1% of participating agencies indicated that they always performed a pressure ulcer risk assessment within 24 hours of admission. After education and training regarding the use of assessment tools, the percentage of agencies performing a risk assessment within 24 hours of admission grew to 71.4%.
"We joined the initiative because we were seeing more patients with wounds," says Paula J. Long , RN, CHCE, administrator of Sullivan County Community Hospital Home Health and Hospice in Sullivan, IN. Not all of the wounds her nurses see are pressure ulcers, but she and her staff recognized the need to incorporate some best practices into their protocols to improve care of wounds.
Although her nurses were conducting skin assessments of all patients, they were not assessing the risk of pressure ulcer development in patients, Long says. "One of the first steps we took was to implement the use of the Braden Scale to assess the...