Module 4: How To Implement the Pressure Injury Prevention Program in Your Organization
Slide Presentation
Slide 1: How To Implement the Pressure Injury Prevention Program in Your Organization
ADD Hospital Name here
Module 4
Slide 2: What We Have Done Thus Far
- Up to this point, you have:
- Looked at your organization’s readiness to improve pressure injury prevention (Module 1).
- Examined current practices and identified aspects needing improvement (Module 2).
- Examined best practices and made preliminary decisions on what best practices will be included in your Pressure Injury Prevention Program (Module 3).
Slide 3: Following Best Practice
- The Implementation Team will work with the Unit Teams and Wound Care Team to implement the new prevention practices.
Image: Photograph shows medical providers looking at a tablet.
Slide 4: Implementation Planning Goals
- Determine the roles and responsibilities of staff in preventing pressure injuries.
- What role will the Unit Team and Wound Care Team play?
- What role will the Unit Champions play?
- When will they be oriented and integrated into the implementation process?
- How should prevention work be organized at the unit level?
Slide 5: Planning Goals
- Plan how you will:
- Put best practices into operation.
- Manage the change process on patient care units.
- Pilot test the new best practices.
Slide 6: Planning Goals
- Plan how you will:
- Get staff engaged and excited about pressure injury prevention.
- Educate staff on new best practices.
Image: Photograph shows medical providers holding a meeting.
Slide 7: Staff Roles
- Assign staff to perform each specific task in your set of best practices, based on training and experience.
Images: Two photographs show medical providers consulting papers and looking at a computer monitor.
Slide 8: Staff Roles
- In some cases, a group will perform the task based on specific roles, such as a group of certified nursing assistants.
- Other tasks may be assigned to a specific person.
- In that case, be sure to assign a backup person.
Image: Photograph shows a medical provider assisting a patient with a mobility device.
Slide 9: List of Best Practices
- Preliminary list of best practices.
Images: An example table for listing best practices and assigning who is responsible for each is shown. An icon of a magnifying glass in front of open book identifies this as Tool 4A.
Slide 10: Staff Roles
Images: Two photographs show medical providers looking at a tablet, and a medical provider standing at a patient’s bedside.
Slide 11: Staff Roles
- Examples of how responsibilities may be assigned.
Images: Two screenshots show a sample table assigning roles to staff members. An icon of a magnifying glass in front of open book identifies this as Tool 4B.
Slide 12: Staff Roles
- Using Tool 4B, think about how you may want to divide responsibilities.
- Members of the Unit Team.
- Hospital staff members whose work brings them to the unit or includes interacting with the unit.
- Consider forming a small Task Force.
- Appoint a Task Force Team Lead, and ask for volunteers to work on this task.
Slide 13: Wound Care Team Role
- Serves as this hospital’s content experts on pressure injury prevention.
- Has experts and resources in current wound care practice.
- May be a formal or informal department, or an individual clinician.
Slide 14: Unit Team Role
- Staff members who provide daily direct patient care by:
- Conducting skin assessments.
- Conducting pressure injury risk assessments.
- Planning care for risk prevention.
- Ensuring care is performed and documented.
Image: Photograph shows two providers looking at a computer.
Slide 15: Unit Team
- The Unit Team works collaboratively with the Wound Care Team.
- Unit staff tell the Wound Care Team about high-risk patients or if skin problems occur.
Image: Photograph shows medical providers having a discussion. An icon of a magnifying glass in front of open book refers to Pages 59-61.
Slide 16: Unit Team
- Make sure you include a written plan for orienting and monitoring temporary staff.
Image: Photograph shows medical providers looking inside a folder.
Slide 17: Unit Champion
- Staff member who serves as the liaison between the Implementation Team, the Wound Care Team, and the Unit Team.
- Most familiar with the program goals, care processes, and outcome data to be used.
- Critical during the implementation process (may be temporary).
- Ideally, one champion per shift, per unit.
Image: Photograph shows a medical provider holding a tablet.
Slide 18: Practice Insight
- Hospital leadership supported:
- Save Our Skin Unit Champion 4-hour boot camp.
- Key result: 40% knowledge increase.
- Bimonthly Unit Champion pressure injury prevention/ wound care lunch and learn sessions.
- Save Our Skin Unit Champion 4-hour boot camp.
Images: Icon of binoculars. Photograph of a flotation device with the logo "To the Rescue … Save our Skin".
Slide 19: Staff Turnover
All hospitals experience the challenges of staff turnover.
Image: Photograph shows medical providers at a patient’s bedside.
Slide 20: Practice Insight
Staff Turnover
Images: Three photographs show medical providers at in-person training, looking at a computer screen, and clapping at a meeting.
Slide 21: Communication Patterns
- Good communication needs to occur among staff at all levels.
- Within the unit (among nurses, nurse assistants, physicians, and patients and their families).
- Among unit staff, the Implementation Team, the Wound Care Team, and senior management.
Images: Three photographs show medical providers at a patient’s bedside, a leader and medical providers having a discussion, and two medical providers looking at papers.
Slide 22: Communication Patterns
- Communicate how changes are actually happening.
- Unit Champions can present updates on implementation at regularly scheduled meetings.
- This can be done thoroughly and succinctly with the least amount of time and effort.
Slide 23: Integrate Prevention Into Ongoing Processes
- Necessary for sustainability.
- Integrated into regular communications (e.g., shift handoffs).
- Make certain procedures (such as skin assessments) universal so staff do not have to decide which patients they apply to.
- Ensure nurses have access to supplies.
- Create visual cues/logos (turning clocks to remind staff when repositioning is due).
- Other examples?
Images: A photograph shows medical providers looking at tablets. An icon of a magnifying glass in front of open book refers to Page 65.
Slide 24: Electronic Health Record Opportunities
- What information about pressure injury risk factors is already part of the patient record?
- What is the most logical place in the record to collect, organize, and assess information about patient pressure injury risk factors and any necessary precautions?
- Additional suggestions?
Images: A photograph shows medical providers looking at tablets. An icon of a magnifying glass in front of open book refers to Page 66.
Slide 25: Manage the Change Process
- Ensure staff understand new roles.
- Ensure staff understand reasons for change and agree change is needed.
- Convey that pressure injury prevention is part of high-quality care and is valued by all, including senior hospital leadership.
Slide 26: Manage the Change Process
- Have adequate access to supplies:
- Dressings.
- Skin creams.
- Engage staff to gain support and buy-in to tailor new practices.
- Encourage staff to speak up if supplies and equipment are lacking, missing, or broken.
Image: Two photographd show medical providers conducting an inventory and applying skin cream to a patient's hand.
Slide 27: Monitor Implementation Progress
- Baseline measures of pressure injury rates and processes should be obtained before any change.
- Tracking care processes to prevent pressure injury is a measure of implementation success and should translate to better outcomes.
- Outcome measures: track changes in pressure injury rates.
- Inform the Implementation Team and staff about results.
Slide 28: Monitor Implementation Progress
- Close the loop.
- Have the Implementation Team report to the unit what it did with the information the unit provided.
Images: Two photographs show medical providers looking at papers and looking at a tablet.
Slide 29: Communicate Success
- Methods for sharing updates and information on successes from prevention activities to the rest of the hospital include:
- Posters with results in the units or lunchroom.
- Newsletter articles.
- Email blasts.
- Announcements on the hospital’s Web page.
- Discussions during staff meetings.
Slide 30: Sustain Pressure Injury Prevention
- Close the information loop. Inform senior leaders and middle managers about progress.
- Keep clinical staff informed about progress with pressure injury prevention.
Image: Photograph shows leaders and medical providers having a meeting.
Slide 31: Staff Education and Training
- Develop an education plan.
- Adults learn best through experiential activities.
- Don’t forget prevention education for the patient and family members and significant others.
Image: An icon of a magnifying glass in front of open book sits beside the text "See Tool 3G: Patient and Family Education."
Slide 32: Staff Education and Training
- You can use a variety of educational approaches, such as didactic methods (e.g., lectures and interactive presentations).
Image: Two photographs show staff members at in-person training and virtual training.
Slide 33: Practice Insight
- Problem: assessment/care plan/documentation.
- Staff Education: RN, CEO, CNO, PCT.
- 2-hour didactic competency training:
- Braden risk assessment and patient comorbidity review.
- 5 in 5 Visual Assessment Tool for pressure injuries.
- Many visuals of actual patients.
- Appropriate interventions based on risk – review of all products.
- How to document implementation and maintenance of plan.
- 1-hour hands-on skills lab – 3 scenarios.
- 2-hour didactic competency training:
- Key results:
- Assessment/care planning accuracy improved from 50% to 90%.
- Continued issue with documentation.
Image: Icon of binoculars.
Slide 34: Group Activity: Assess Staff Education
- Assess current staff education.
- Assess educational needs.
Images: A screenshot shows a sample Facility Assessment tool. An icon of a magnifying glass in front of open book identifies this as Tool 4C.
Slide 35: Staff Knowledge Assessment
Image: Photograph shows hospital staff taking knowledge assessment.. An icon of a magnifying glass in front of open book refers to Tool 2G: Pieper Pressure Ulcer Knowledge Test.
Slide 36: Staff Education and Training
- Regular/ongoing education means including pressure injury prevention in four areas of training:
- Annual education for all staff.
- Staff competencies.
- New staff orientation.
- Training of temporary staff.
Image: Photograph shows staff members at training.
Slide 37: Practice Insight
Images: Icon of binoculars. A screenshot shows the Pressure Ulcer Prevention Program Action Plan: June 2015 - January 2016. Key Interventions 3 and 4 are circled in red.
Slide 38: Action Plan
Action Steps for Key Interventions 3 and 4
Images: A screenshot shows a sample Action Plan with Key Interventions 3 and 4 circled in red. An icon of a magnifying glass in front of open book sits above the text "Refer to your Action Plan."
Slide 39: Summary
- To summarize, we addressed the following:
- Roles and responsibilities of the Unit Team,.
Wound Care Team, and Implementation Team in preventing pressure injuries. - Importance of the Unit Champions.
- Communication during implementation.
- Staff training needs to learn new practices.
- Action Plan for putting the prevention program into practice.
- Roles and responsibilities of the Unit Team,.