Making the Skin Initiative Work

1. Making the Skin Initiative Work By Jeanna Lisman RN, MSN

2. Keys to Success • Team Approach/Involvement • Education • Communication • Documentation • Patient Safety

3. Team Approach • Involve Everyone – Must include all staff: CNA’s, LPN’s, RN’s, House Supervisors, Dietary, Physical Therapy, and Administration • Staff Buy In – Acceptance of responsibililty by all staff members

4. Hourly Rounding – Provides a continuum of patient care • Home Health Care – Working together • Develop Committee – Form a group of staff that are interested in the success of the skin program

5. Education • In-services, staff meetings, and train the trainer -Inservices provided by wound care companies and various experts • New Staff – Provided in orientation packets and preceptor covers information person-to-person • Yearly Skills Labs/Competency Check Off – Annual competence (mandatory)

6. Individualized and Informal education – Real time and hands on education • Certifications – Sent three staff to be certified in wound care • Webinars – Skin care and equipment representatives offer online education

7. Skin Model – Ordered Seymour Butt to use in skills week and when staff need individualized training • Quick Reference Guides – Laminated badge cards, quick reference in all charts, and reference book placed on all medication carts • Off site education – Sent staff to other wound care facilities

8. Communication • Care Coordination – Involve other facilities to coordinate and improve skin care issues; meet every other month • Person-to person – Very important when identifying pressure ulcers and the treatment • Shift-to-shift • Department-to-department • Facility-to-facility

9. Revised transform forms – To provide better communication to accepting facilities • Revised report sheets – To improve staff awareness and communication • Data Collection – Collecting data to report to state and is shared with staff

10. Documentation • Digital Imaging – Digital cameras and printers were purchased and placed on the Medical Surgical and ICU units. Photos are taken upon admission, with any change, and upon discharge • Incorporated Braden Scale – Braden Scale is assessed every six hours and is placed on our Medi-tech system. The Braden Scale is used to involve appropriate disciplines in patients plan of care.

11. Complete revision of skin assessment documentation – Involved staff to obtain and make changes to our existing documentation • Review of all skin assessments – All skin assessments are reviewed on an ongoing basis • Developed protocols – Interdisciplinary effort to create new protocols to improve the standard of care

12. Patient Safety • Preventing pressure ulcers reduces the risk for infection • Implementation of the Skin Care Initiative in our facility has taken our documentation from a substandard level to exceeding the standard of patient care

13. Questions????