Leading Practices in Geriatric Care: Building a Dermal Defense Team Makes a Difference!

The task of building and maintaining a dermal defense team requires commitment from all hospital units and administration.  This commitment begins with the creation of a champion role. Each unit in the hospital has a nurse champion who represents the unit and each champion performs monthly prevalence studies, educates staff, and communicates findings via email and poster presentations. Education of champions starts with NDNQI pressure ulcer education using the four modules to teach staff how to perform a prevalence study. Once this education was complete the staff rounds with the dermal defense team (DDT) leader to review skills by doing an inter-rater reliability test. This education was so successful the nursing administration approved this education for all nursing staff. This led to nursing and ancillary staff acceptance of accountability for vigilant effort to reduce pressure ulcers.  Monthly continuing education is provided for the DDT and the team disseminates this information to the unit staff. Quality care is maintained with team effort of nurses and patient care technicians (PCT). Many units have both a nurse and a PCT champion on the DDT. Leading successful dermal defense teams happen when the interest of the team members is held. This interest is sparked by having a dermal day each spring. The DDT members have an opportunity to share their knowledge by creating posters using evidence-based practice guidelines. The posters are presented to staff and continuing education is provided. Each DDT member has an opportunity to shine and this keeps the team alive. Each team member is held accountable for keeping the unit staff up to date on all new dermal products and if a unit-acquired pressure ulcer occurs, team members discuss with colleagues to prevent this from occurring again.