CARY, Ill., (September 24, 2009) Implementation of an Interventional Patient Hygiene (IPH) program that clearly defines comprehensive bathing and incontinence practices and education in the hospital intensive care unit can significantly reduce pressure ulcers (PrUs), according to a recent study at the Vanderbilt University Medical Center. Vanderbilt found the incidence of new PrUs decrease from 7.14 percent at baseline, to zero upon conclusion. As hospitals streamline process to minimize costs, the study suggests that educating nurses or nurses' aides on patient hygiene protocols is more important than ever to improve quality of care.
Nationwide, hospitals spend up to $8.5 billion per year in treatment costs for PrUs1 , conditions that can be prevented with staff compliance to simple, science-based guidelines. PrUs and impairment of skin integrity increase a patients risk of developing a hospital-acquired infection (HAI) by 26 percent2, a condition that is directly related to nursing care measures. It is estimated that 1.75 million to 3.5 million patients admitted to U.S. hospitals or 5 percent to 10 percent of all patients-contract HAIs3, leading to 100,000 deaths annually.
The economic impact of these patient intervention programs is increasingly important with the addition of PrUs to Centers for Medicare and Medicaid Services' list of "never events." "Everyone has heightened awareness of the problem, but we should have quality focus all the time," said Devin Carr, MSN, RN, ACNS-BC, and lead researcher on the study. "It is essential for hospitals to commit to an IPH program that encourages staff to communicate and work together on doing the right thing for safe patient care."
The reduction of PrUs at Vanderbilt is attributed to the education and quality-improvement program with 100 percent of nonlicensed intensive care unit staff following facility protocol. "With this IPH program in place, facilities profit from a more simplified, standardized process. They can decrease the number of different products used to a single product line, and have a nice tool for communication and staff collaboration," said Carr.
Two components of IPH were addressed: skin cleansing and incontinence management. A preintervention survey uncovered the staff's knowledge in six areas related to skin integrity, PrUs, and the facility's skin care protocol.
The survey results showed a need for education in three areas: the facility's policy to report changes in skin conditions; the facility's incontinence protocol; and protocol regarding incontinence cleanup. For the patient intervention, evidence-based bathing and incontinence prevention protocols were used. The bathing protocol emphasized that caregivers move away from the traditional bath basin, a reservoir for infectious bacteria, and replace it with a prepackaged washcloth.
The cleansing system used in this study was Comfort BathÒ washcloths, manufactured and distributed by Sage Products. These washcloths also include peel-and-stick Skin Check™ labels that allow nurses and nurses aides to pinpoint areas on the body where skin integrity has changed, and should be checked for potential problems. Sage's Comfort ShieldÒ Barrier Cloths were used for incontinence management, featuring a Peri Check™ Guide to encourage all levels of staff to report broken or discolored skin.
This enhanced communication between nonlicensed staff and nurses not only improved patient outcomes, but also empowered the staff to work more efficiently and easily together - which is a concern for many facilities driven to improve patient care under staff shortages.
References: 1.Beckrich K, Aronovitch SA. Hospital-acquired pressure ulcers: a comparison of costs in medical vs. surgical patients. Nurs Econ 1999; 17:263-71. 2. Allman RM, Goode PS, Burst N, et al. Pressure ulcers, hospital complications, and disease severity: impact on hospital costs and length of stay. Adv Wound Care 1999; 12:22-30. 3. Exner M, Kramer A, Lajoie L, Gebel J, Engelhart S, Hartemann P. Prevention and control of health-care associated waterborne infections in health care facilities. Am J Infection Control. 2005; 33 (5 suppl): S26-S40.
|
