Studies show that pressure ulcers are a common occurrence across our healthcare system – in hospitals, residential facilities and community care settings. The impact of these wounds is profoundly negative on patients, families and caregivers, and the costs incurred by the healthcare system can be exorbitant. However, pressure ulcers can be prevented or detected early and treated to minimize harm.
To learn more about the prevalence of pressure ulcers in BC and where improvements could be made to prevent them, better information was needed.
In late 2013, the Provincial Nursing Skin & Wound Committee and the BC PSLS Central Office team began a collaborative partnership to look at how data collection using BC PSLS could be enhanced. Under the leadership of chairperson Shannon Handfield from Vancouver Coastal Health, the group explored and discussed several key questions: Why and where are pressure ulcers occurring? Who is most affected? At what point of care do pressure ulcers happen most often? Are assessments and prevention efforts being applied consistently? And, how can BC PSLS data support learning and improvement across the care continuum?
For several months the group worked together to design a new specialized form for pressure ulcer reporting.
On February 14, the new form was launched across the province, giving care providers in all areas a more comprehensive and simpler way to report pressure ulcer issues. For example, the new form includes specific questions about pressure ulcers (Braden Scale compliance), context-specific examples and degree of harm descriptions. We introduced the new form as part of the province-wide “Let’s take the pressure off!” campaign, which included buttons, bulletins, and “how to” tips for staff.
As expected, we can already see a noticeable increase in pressure ulcer reporting from all health authorities, which tells us that the new pressure ulcer report form and awareness campaign is bringing a greater focus on this issue across BC. But is it resulting in better patient care?
To gain some perspective from one Lower Mainland facility, I recently spoke with Lisa Hegler, Skin and Wound Clinician at Burnaby Hospital. Lisa has been a passionate advocate for wound care management throughout her healthcare career and an integral part of this initiative since the beginning. She says pressure ulcer awareness has come a long way.
“Speaking on behalf of our facility I would say we’ve implemented several positive changes in our acute hospital. We now have the new pressure ulcer report form, care providers can identify pressure ulcers early on before they become serious and we review our BC PSLS data on a regular basis. All of this adds up to better patient care. I think of these threads as a ‘tapestry’ and it’s wonderful to see it all coming together so well. I’m very proud of how far we’ve come.”
Not long ago, Lisa says Burnaby Hospital didn’t have a wound clinician or a wound care program, and their pressure ulcer incidence rate was 62%. Today, it’s down to 12%. “That’s a significant improvement for us and it’s why we emphasize pressure ulcer prevention, early detection and early intervention.” In addition, the organization has seen a decrease in the incidence of stage 3 and 4 pressure ulcers – deep tissue wounds – improving patient outcomes, freeing up nurses’ time and saving healthcare dollars.
Lisa says staff education is fundamental. At Burnaby Hospital they initiated an innovative teaching program for staff using real photos of pressure ulcers.
“Diagrams and drawings aren’t effective,” says Lisa. “Nurses need to see exactly what pressure ulcers look like. I’ve also found that real images get people talking – it’s not about sugar-coating this issue, it’s about learning what is needed to ensure quality care.”
BC PSLS Central Office will continue to work with Shannon, Lisa and the entire Provincial Nursing Skin & Wound Committee to help them learn more about pressure ulcers and what needs to be done in BC to prevent them. Check back for more blog posts as this topic will be a running series to showcase the work care teams are doing to prevent pressure ulcers at facilities throughout BC.
Congratulations to the staff at Burnaby Hospital and all care providers who are working hard to prevent pressure ulcers and improving patient care. Your efforts are making a difference!
Lisa Hegler is a Skin and Wound Clinician at Burnaby Hospital. She has worked in healthcare for more than 23 years and is certified and specializes in the treatment of wounds, ostomy and continence issues. You can reach Lisa by email at firstname.lastname@example.org
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