Committed to improving the prevention of pressure ulcers, Coney Island Hospital in Brooklyn, N.Y., developed strategies to increase accurate evaluations, track ulcer status and communicate with long-term care facilities. More than 90% of the hospitals patients with pressure ulcers are admitted from nursing homes and community housing for the elderly. Utilizing the fundamentals of executive nurse competencies, the hospital tackled this issue by involving all team members involved with this quality and safety issue.
By implementing a transparency philosophy in 2009, the hospital was able to incorporate information technology and digital imaging into its standard of care. Every patient, regardless of a present-on-admission or newly acquired pressure ulcer, now has a digital image and full evaluation with treatment recommendations taken within 24 hours of discovery. The hospital also purchased software that provides a systematic and efficient method for evaluation and tracking. The image, with a full assessment and treatment recommendation, is scanned into the electronic medical record. All members of the interdisciplinary team can review the images and evaluations.Coney Island Hospital staff, from left, Laura Battaglia, RN, director of quality management; Marie Torell-Alverio, RN; and Molly Albert, LPN.
Because of the new standard of care, Coney Island patients no longer are exposed to frequent observations by different healthcare providers and dressings are not constantly removed to observe the ulcer. Information technology also has increased the accuracy of assessments from 50% to 100%. All required essential elements for assessment are present on one form with the digital image.
Wound care clinicians were seeing many patients admitted from long-term care facilities with multiple pressure ulcers. In 2006, a transitioning methodology was implemented so staff could collaborate with local long-term care facilities and offer educational classes on best practices. This was received well by these facilities and opened ongoing collaboration. As a result, best practices were adapted and continuity of care between acute and long-term facilities was achieved. By continuing to partner with long-term care facilities, the hospital aims to reduce the number of facility-acquired pressure ulcers by 25% each year. As a result of hospital staffs efforts, one nursing home also adopted the same software program and Coney Islands facility-acquired rate decreased by 60% in 2009 and has continued to decline in 2010.
For information on the program, call 718-616-3686 or e-mail Marie Torell-Alverio at [email protected]