The Pressure Ulcer Prevalence Survey team from March 2015

Four times per year, a group of 40 nurses and Patient Care Services professionals participate in the day-long hospital-wide Pressure Ulcer Prevalence Survey Day. The goal for the day is to thoroughly examine BWH inpatients for pressure ulcers. Pressure ulcers can develop for a number of reasons, from complex medical and nursing needs to extended pressure on an area of the body.

“This day is essential to our patients’ safety and well-being and for our hospital’s health as a whole,” said Diane Bryant, MS, RN, CWOCN, certified wound ostomy clinical nurse specialist. “When found early, pressure ulcers can be treated successfully, minimizing patients’ discomfort.”

Nurses regularly check their patients in order to prevent pressure ulcers from forming, and the survey day serves as an important step to ensure that BWH is doing everything possible to prevent pressure ulcers. Research shows that hospital-acquired pressure ulcers and their complications lead to longer hospitals stays and increased health care costs.

On the most recent survey day in March 2015, nurses started off with an hour-long educational session that covered identifying and staging pressure ulcers. Data collection and treatment information were also discussed.

Bryant and colleagues Mary Willis, MS, RN, CWOCN, and Ilene Fleischer, MS, RN, CWOCN, certified wound ostomy clinical nurse specialists, have collaborated with the Department of Nursing quality program  for the survey for the past nine years and developed its educational component. “We try our best to make it interactive and fun,” said Willis. “Everyone involved volunteers to participate, with the support of their nurse director, so we try to make it the best learning experience possible.”

Adds Fleischer: “This day is truly great for both new and seasoned nurses. You work in a different part of the hospital, with a new patient population and BWH staff that you may not otherwise encounter.”

Once the educational portion is complete, 10 teams begin their day by visiting ICUs and intermediate care units, where they check patients for pressure ulcers. Each team consists of four participants, which may include clinical nurses, an ICU nurse, a clinical nurse educator and a Patient Care Services professional. The teams partner with nurses on the units to check each patient and engage in a discussion about prevention and treatment of the pressure ulcer.

At the end of the day, most inpatients in the Tower, Shapiro and some in the Connors Center for Women’s Health have been examined from head to toe and the appropriate data for each patient has been collected. Data is entered into the National Database of Nurse Quality Indicators (NDNQI) and the Massachusetts Patients First database. Sharing information in these databases allows patients and providers to see how BWH compares with other acute care hospitals. Finally, data is analyzed, and trends are identified to help improve practice.

“Hospital-acquired pressure ulcers that meet the definition of serious reportable events are reported to the Department of Public Health,” said Bryant.

“This collaboration with the CWOCNs, clinical nurses, members of the inter-professional team and our quality team strengthens us as a department and helps us advance our goal of preventing hospital-acquired pressure ulcers,” said Deborah Mulloy, PhD, RN, associate chief nurse for quality and the Center for Nursing Excellence.

The day concludes with much excitement from team members, who enthusiastically share their new knowledge and discuss their desire to become skin care champions for their units.

“Many people from all different levels at BWH come together to make this day happen,” said Bryant. “We have clinical nurses, clinical nurse educators, nursing students and professionals from Nutrition, Respiratory Therapy and Physical Therapy contributing to this effort.”

Willis added: “It takes a village. We could never do this without the support and contribution of our colleagues.”

The next survey is planned for June 17th.