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A Performance Improvement Project to Increase Nursing Compliance with Skin Assessments in a Rehabilitation Unit

Revello, Kathleen BSN RN CRRN; Fields, Willa DNSc RN FHIMSS

doi: 10.1002/RNJ.00006

Purpose The aim of this quality improvement project was to increase nursing compliance with skin assessments and ultimately decrease Hospital Acquired Pressure Ulcers (HAPUs) in an acute rehabilitation center.

Methods Interventions in this quality improvement initiative consisted of education, twice-weekly skin rounds, nursing assistant participation, and sharing of pressure ulcer data.

Results The educational sessions were attended by 80% of the nurses and 95% of the nursing assistants. The remaining nurses and nursing assistants were educated in one-to-one sessions, for a total of 100% of the staff. After the education, skin assessments documentation was completed 100% of the time. The March 2010 CalNOC results demonstrated no patients with HAPUs (Figure 2), which demonstrates a zero incidence of HAPUs since December of 2008.

Conclusions The education, skin rounds, nursing assistant participation, and sharing of data were instrumental in improving the frequency of skin assessments and the reduction of HAPUs in the rehabilitation unit.

Clinical relevance Skin rounds and staff education not only increased nursing accountability and improved documentation of wounds but also helped promote the healing of patient's current skin issues.

Kathleen Revello, BSN RN CRRN, is Educator and Lead Nurse at Sharp Grossmont Rehabilitation Center, La Mesa, CA. Address correspondence to

Willa Fields, DNSc RN FHIMSS, is Professor, San Diego State University School of Nursing and Program Manager, Sharp Grossmont Hospital, La Mesa, CA.

© 2012 Association of Rehabilitation Nurses.
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