Pressure ulcers are a common medical problem that negatively impact patients’ lives, causing pain, scarring, and possibly death. In this third article of our Let’s take the pressure off! series, we’re pleased to highlight the Skin and Wound Care Practices team from Interior Health. We hope others can benefit from their successful approach to pressure ulcer prevention so we can reduce the incidence of pressure ulcers, and improve patient safety across our healthcare system.
Interior Health provides services and programs to approximately 750,000 people living in British Columbia’s southern interior. With over 20,000 healthcare staff spread out across the region, a well-coordinated education program is critical for pressure ulcer prevention to be effective in such a large and diverse organization.
Over the past year, Laureen Sommerey, Project Leader, Skin and Wound Care Practices, Sharon Campbell, Occupational Therapist (Kelowna), Ruth Harris, Enterostomal Therapy Nurse (Penticton), Coleen Welton, Enterostomal Therapy Nurse (100 Mile House), Amanda Bartlett, Physiotherapist (Kelowna), and Interior Health’s Regional Skin and Wound Committee have been spearheading a widespread pressure ulcer awareness and prevention campaign that’s reaching thousands of staff and showing positive early results.
Skin & Wound Care Practices Update (July 2016, page 1)
Skin & Wound Care Practices Update (July 2016, page 2)
Above all, the team’s goal was to increase reporting of pressure ulcers in BC PSLS, which has tripled in the past few months. And the team has been working tirelessly to communicate to staff that pressure ulcer reporting creates an opportunity to improve patient care, and is not a reflection of poor quality care.
“We’re very happy to see reporting rates going up,” says Laureen. “We want staff to report without feeling shame or guilt. That’s how we learn. I think that message is getting through now, which is great!”
Education sessions
The team provides regular WebEx and in-person education about skin and wound care practices, the Braden Scale, pressure ulcer prevention strategies, and ostomy care, often using patient stories as examples.
Newsletter
The monthly Skin & Wound Care Practices Update contains tips about skin and wound care, including how to report pressure ulcers in BC PSLS, how to determine pressure ulcer stages based on example images, and risk factors to watch out for such as diabetes, Incontinence Associated Dermatitis (IAD), prolonged sitting or lying, and poor nutrition.
eLearning (Available to Interior Health staff only)
Self-learning modules about pressure ulcer staging, wound assessment, and wound care/cleansing are available to all Interior Health staff.
Pamphlet for patients and families
The Preventing Pressure Ulcers pamphlet offers practical tips for patients and families such as how to identify skin breakdown, how to maintain mobility while in hospital, and the importance of repositioning.
Preventing Pressure Ulcers pamphlet for patients and families (front)
Preventing Pressure Ulcers pamphlet for patients and families (back)
The team is also keeping a close eye on their BC PSLS data to inform continuous development of their pressure ulcer education program.
Pressure Ulcer Stages help staff determine Degree of Harm to the patient.
One of the learning needs identified is helping staff to understand that it’s important to report pressure ulcers at all stages. While approximately 80% of reported pressure ulcers are Stage I or Stage II (minor or moderate harm), early detection allows for the implementation of additional preventative measures to decrease the risk of additional damage occurring.
“That’s why this education is really important. Healthcare staff in all areas of care should know how to recognize the early signs of skin damage, before a pressure ulcer develops or becomes worse.”
And, although Laureen says reporting rates are still relatively low for an organization the size of Interior Health, she’s thrilled with their achievements so far and believes they are moving in the right direction.
“Our team is very passionate about this – it’s a work in progress and we’re getting there!”
Pressure ulcers always result in harm to the patient:
- Stage I pressure ulcer = Degree of Harm 2 – Minor
- Stage II pressure ulcer = Degree of Harm 3 – Moderate
- Stage III, IV, Suspected Deep Tissue Injury (SDTI), and Unstageable = Degree of Harm 4 – Severe
Assigning a Degree of Harm does not imply blame, it just describes the impact of the pressure ulcer on the patient.
As a healthcare provider you are encouraged to report concerns about your patients in BC PSLS. With your help we can improve pressure ulcer care and prevention at Interior Health and across the province.
Thank you!
Learn more about:
- Preventing pressure ulcers: Keeping the pressure on to take the pressure off! (Part 2)
- Pressure ulcers: Raising awareness and promoting prevention in BC (Part 1)
- Protecting patients from pressure ulcers at Royal Inland Hospital
- Accreditation Canada Required Organizational Practices 2016
- Taking the pressure off! How Burnaby Hospital achieved remarkable improvements with pressure ulcer incidence
To learn more, please contact Laureen by email at laureen.sommerey@interiorhealth.ca
Laureen would like to thank all Interior Health staff for their commitment to pressure ulcer prevention, and express her sincere appreciation to the following individuals for working with her on this important patient safety initiative:
- Colleen Harris-Smith, Dietitian
- Morag Green, Quality Improvement consultant
- Alison Gregory, Quality Improvement consultant
- Allison Griffiths, Quality Improvement consultant
- Andrew Hiob, BC PSLS Coordinator, Interior Health
BC PSLS Central Office would like to take this opportunity to acknowledge Laureen, the Skin and Wound Care Practices team, and all frontline staff at Interior Health for their commitment to patient safety. Thank you for sharing your story with us!