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Vancouver Coastal Health - Richmond
Pressure Ulcer Prevention
An Interdisciplinary Approach
BCPSQC Quality Forum 2015
Lisa Stewart Maria Torres
Disclosure Statement Both presenters are employees of Vancouver
Coastal Health and declare no potential conflicts of interest.
“A pressure ulcer is localized injury to the skin and/or underlying tissue usually over a bony
prominence, as a result of pressure, or pressure in combination with shear…”
International NPUAP-EPUAP Pressure Ulcer Definition
Pressure Ulcer Risk Scale completed by the interdisciplinary team at R-Care
Pressure Ulcer risk assessment and care planning is interdisciplinary
Nutrition
Mobility
Activity
Sensory Perception
Moisture
Friction & Sheer
Comorbidities
BMI
Medical Status
Lab Values Medical History
Age
Hydration
Comparison of Total Braden Scale Score - Interdisciplinary Team and WOCN
0
5
10
15
20
25
30
35
40
IDT Total
WOCN Total
Comparison of Braden Scale Score - Interdisciplinary Team and WOCN
Sensory Moisture Activity Mobility Nutrition Friction and Shear
0
0.5
1
1.5
2
2.5
3
0.18 0.18
0.40.25
0.50.4
Richmond Hospital Pressure Ulcer Prevention Accreditation Standards Met
Medicine 1 Medicine 2 medicine 3 Surgery 1 Surgery 2 Palliative Care Critical Care0
1
2
3
4
5
2014 Average 97.3%
January February March April May June July September October December0
20
40
60
80
100
91.298 100 100 99.7 98.6 96 94.6 97.3 97.7
Richmond Hospital Patients with a Completed Pressure Ulcer Risk Screen (%)
January-December 2014
“The process is great for allowing you to very quickly visually note the problem
areas for that particular patient ultimately allowing you to prevent sores
from progressing”
“Although we all know the key boney areas of the body most at
risk, every patient is different. This form allows for patient
centered documentation and prioritization of your care
strategies and goals”
“Having a designated location and a standardized way of documentation/communication assures us
that patients have their pressure ulcer risks addressed every single day”
“It makes you really think about and consider the high risk skin areas. It also allows the nurse to see what areas may
be of concern specific to that patient and concentrate on their assessment and care
before they progress”
“It is a good tool in that it allows you to see immediately when there has been a
change in a patients skin condition”
January February March April May July August October0
1
2
3
4
5
6
0 0
1 1
0
1
0
5
Pressure Ulcer Prevalence Palliative Care January-October 2014