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Denise Dean, R.N., left, and Patricia Galo, R.N., turn patient Cy King to help prevent pressure ulcers, commonly known as bedsores. (photo by Neil Brake)

Prevention program helps unit cut down on bedsores

BY: LESLIE HAST

6/20/2008 - The staff of Medical Center North's seventh-floor round wing (7RW) has shown success in preventing pressure ulcers as part of the Pressure Ulcer Prevention program (PUPS), and they have the numbers to prove it.

In four of the last five surveys, the medical/surgical patient care area has had hospital-acquired pressure ulcer rates below 15 percent, the national target.

For three out of five of those surveys, they had zero hospital-acquired pressure ulcers.

A pressure ulcer, commonly known as a bedsore, is a wound or sore that occurs when blood supply is cut off to an area because a patient sits or lies in one position too long.

The occurrence of pressure ulcers can lead to pain, a longer hospital stay and slower recovery.

Also, beginning Oct. 1, the Centers for Medicare & Medicaid Services (CMS) will not pay for pressure ulcers that either develop or worsen while a patient is in the hospital. The reduction of hospital-acquired pressure ulcers is now a safety and quality indicator for various agencies. Because of this, there is an important focus on prevention.

“Pressure Ulcer prevention is a very important aspect of patient care at Vanderbilt,” said Bonnie Thompson, R.N., a member of the PUPS committee who rounds on 7RW.

“The 7RW experts and staff, along with many other units, continue to be vigilant in their mission to decrease the pressure ulcer rates below the national benchmarks.”

A key to the floor's success, said Kaye Stobaugh, R.N., interim manager of 7RW, is the intense training that seven staff members have undergone to become a “PUPS Expert.”

The experts participate in institution-wide quarterly pressure ulcer surveys, weekly unit skin care rounding and various committees related to pressure ulcer prevention and treatment.

These experts are Christine Anderson, L.P.N., Denise Dean, R.N., Luisa Doromal, R.N., Pat Galo, R.N., Rodney Norton, L.P.N., Jane Patey, R.N., and Ernestine Swift, R.N.

All new staff on 7RW are also required to undergo the daylong training class to become PUPS experts, which is provided three times a year by the Vanderbilt Wound, Ostomy and Continence Nurses and is a continuing education unit offering.

The next class is scheduled for Nov. 4 and is open to all nurses and care partners.

Once trained as a PUPS Expert, staff continue their education by attending quarterly classes to share ideas and hear presentations by various speakers about pressure ulcers, wound care and pressure redistribution products and techniques.

The next class will be July 16.

“This training has been one of the best measures,” Stobaugh said. “It goes a step above normal nurse's training. The more knowledge the better — it's part of being proactive and keeping the good momentum going.”

With pressure ulcers reduced on their floor, the nurses have now set their sights on decreasing patient falls.

“We've got a really great staff up here,” Stobaugh said. “They have a lot of really good ideas.”

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