Healthy Skin Wins: A Glowing Pressure Ulcer Prevention Program

Pressure ulcers (PUs) are one indicator of the quality of health care. The prevalence of PUs in acute care hospitals in Canada is estimated at 25.1% with half of PUs assessed as Stage 1. In 2013, an observational survey using a modified Braden Scale was conducted among 272 patients in an acute care hospital located in a Western Canadian city. The prevalence rate of PUs was 34.9% with only one third of the PUs at Stage 1. In this poster presentation, we describe how a multidisciplinary research team implemented and evaluated a PU prevention program (PUPP). The multi-disciplinary research team was comprised of a physiotherapist, an occupational therapist, a dietician, wound care specialists, and several nurses. The team used the Iowa Model of Evidence-Based Practice to Promote Quality Care in conjunction with Rogers’ Diffusion of Innovations Model as guiding frameworks. The PUPP included the establishment of specialized mattresses hospital-wide, new products for patients with incontinence, use of sliders, and discontinued use of soaker pads. A staff awareness campaign was launched; it was entitled, “Healthy Skin Wins” with posters and weekly newsletters about changes in practice, nutritional support for at-risk patients, and a 20-minute online tutorial about PUs and PU prevention. A mixed methods study, funded by the Manitoba Centre for Nursing and Health Research, was employed to determine the effectiveness of the PUPP with a pre-test/post-test design, a repeat observational PU prevalence survey, and three focus group interviews. Health care aides, licensed practical nurses, registered nurses, and allied health care professionals were invited to complete an anonymous 18-item knowledge assessment tool before and after an online tutorial about PU prevention using FluidSurveys.com. Eighty staff members volunteered to participate in the pre-test/post-test with a statistically significant increase in their knowledge about PUs and PU prevention. A repeat PU prevalence observational survey was conducted after the launch of the PUPP in 2014 with 240 in-hospital patients, and a statistically significant reduction in the prevalence rate (7.5%). Following analysis of the quantitative data, health care aides, nurses, and allied health professionals were invited to participate in three semi-structured, audio-recorded focus group interviews to share their perceptions of the PUPP. The audio-recordings of the interviews were transcribed verbatim. Transcripts were read and reread to facilitate a process of thematic analysis to describe hospital staff’s experiences of the PUPP. In this poster presentation, we share the results of the mixed methods study that determined the effectiveness of the PUPP. This mixed methods study can be used as a template to incorporate and evaluate evidence-based practice changes in various health care facilities around the world.