Iowa and Nebraska Hospitals Partner to Prevent Pressure Ulcers

Hospitals in Nebraska and one in Iowa are working to improve clinical quality by preventing and reducing pressure ulcers. The hospitals have joined a Rapid Adoption Network (RAN), a virtual network that allows them to share information about clinical practices to accelerate the pace of clinical improvement. The RAN is sponsored by VHA Inc., the national healthcare alliance.

The timing of this program is important because Medicare and many private insurers have said they will no longer reimburse hospitals for the additional cost to treat pressure ulcers that develop in hospitalized patients.

A focal point for the RAN will be a clinical blueprint VHA developed to help its members prevent or reduce the incidence of pressure ulcers.  This blueprint captures the clinical processes and people factors that drive superior performance at leading hospitals.

“We launched our pressure ulcer RAN in August and since then we’ve observed that participating hospitals have developed some really interesting and creative approaches for prevention,” said Jenny Larrison, RN, MSN, director of performance improvement and pressure ulcer RAN coordinator for VHA’s Mid-America office. “A serious lack of resources is driving hospitals, especially small community hospitals, to develop methods to support education, and find new ways to deliver best care.”

One hospital that has implemented creative tactics to keep pressure ulcer incidence near zero is Community Hospital in McCook, Neb.

“We decided to participate in VHA’s Pressure Ulcer RAN to learn new approaches for addressing, preventing and eliminating pressure ulcers,” said Kandace Ulrich, RN, BSN, skilled care, utilization review, risk management and wound care coordinator at Community Hospital. “We’ve learned and adopted a variety of new techniques that have helped us to keep our PU rates near zero since June 2008, with only one case reported in August.”

Creative tactics include:

-- Crafting a construction paper clock and taping it to the door of each patient room. The clock is reset every two hours indicating that the patient has been turned.

-- Hosting a wound care educational fair for clinical staff for nurses to learn about wound care and the various wound stages. The fair will feature images, dressings and speakers.

-- Developing a skin communication form that features a diagram of the front, back and sides of a human body. Clinicians use one form per patient and circle body areas that are of concern. The form is completed upon admission, during each shift change and during bathing.

The following hospitals are working on this project:

Columbus Community Hospital, Columbus, Neb.

Community Hospital, McCook, Neb.

Faith Regional Hospital, Norfolk, Neb.

Nebraska Methodist Health System, Omaha, Neb.

Tri-county, Lexington, Neb.

Jennie Edmundson Hospital, Council Bluffs, Iowa

A Rapid Adoption Network is one component of VHA’s overall clinical improvement services platform, which also includes:

-- Leading Practices Portal – a Web site that enables VHA hospitals to access information about their performance in specific clinical areas and compare their performance with other hospitals regionally and nationally.  The site helps hospitals identify gaps in their performance and points the hospitals to resources for improvement

-- Leading Practice Blueprints™ – Sophisticated, yet simple to follow, process maps based on anthropological research at top performing VHA members. These blueprints were developed by carefully studying the clinical processes and people factors, as well as hidden factors  that are important to each leading practice hospital and integrating these elements into a powerful visual format

-- Clinical Educational Series – Multimedia formatted educational programs provide year-round access to leading performers and leading practices

Source: VHA Inc.