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Learning Objective 1: to discuss the premise of the Skin Care Bundle and the six important components.
Learning Objective 2: explain the measures of success of the Skin Care Bundle and the impact on nursing outcomes.
To share the research conducted on the effectiveness of a Skin Care Bundle (SCB) which demonstrated a direct link to Evidence Based Practice (EBP). Traditional care practices among critical care units in the prevention of hospital acquired pressure ulcers include turning and positioning, pressure redistribution surfaces, maintaining the head of the bed at no greater than 30 degrees, nutrition, perineal cleanser, and moisture barriers.
The experience of the CCU nurses in pressure ulcer prevention and in providing care to a high risk population ensured the high-reliability of the SCB. The bundling of the 6 components of the SCB provided continuous availability of the EBP, as well as a high level of insurance in maintaining the all or nothing approach of the SCB, thereby maximizing pressure ulcer prevention in CCU.
Methods:
This is a quantitative study, which received a waiver of consent from the IRB. Standard statistics were utilized to evaluate the effectiveness of the SCB. Prior to initiating the SCB, a baseline data collection was conducted which included 62 CCU patients and was equal to 775 patient days. This daily data collection included 30 data points.
Results:
The statistical analysis of the pre-bundle data showed that these patients who were most clinically unstable did not acquire pressure ulcers, while the 30.65% that did develop ulcers were the patients awaiting placement. The CCU staff was educated on the SCB and the bundle was implemented. 453 patients, equivalent to 4,607 patient days, were evaluated on 36 data points and the incidence of CCU acquired pressure ulcers decreased to 4.86%.
Conclusion:
The SCB has since been implemented hospital wide and the prevalence of hospital acquired pressure ulcers continues to decrease dramatically. The SCB created a redundant concept across the entire hospital for critical applications of EBP at the bedside.