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Improving Outcomes by Implementing a Pressure Ulcer Prevention Program (PUPP): Going beyond the Basics.

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Implementing a multidisciplinary program significantly reduced hospital-acquired pressure ulcers (HAPU) incidence. Strategic interventions, including new surfaces and staff, maintained low HAPU rates long-term.

Keywords:
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Area of Science:

  • Healthcare Management
  • Patient Safety
  • Nursing Practice

Background:

  • Hospital-acquired pressure ulcers (HAPU) represent a significant challenge in healthcare settings.
  • Effective strategies are crucial for reducing HAPU prevalence and improving patient outcomes.
  • The University of Miami Hospital (UMH) initiated a program to address HAPU rates.

Purpose of the Study:

  • To identify the prevalence of HAPU at UMH.
  • To implement evidence-based interventions aimed at reducing HAPU incidence.
  • To evaluate the long-term effectiveness of these interventions.

Main Methods:

  • A multidisciplinary committee-driven process improvement program was established.
  • Key interventions included replacing support surfaces, updating care protocols, optimizing turning schedules, and hiring specialized staff (WOC nurse).
  • Continuous monitoring of HAPU rates and introduction of new skin products with re-education were employed.

Main Results:

  • Initial interventions reduced HAPU prevalence from 11.7% (Q2 2009) to 2.1% (Q3 2009).
  • After a temporary rise in Q1 2012 (4.1%), further interventions led to a decrease to 2.76% (Q2 2012).
  • HAPU rates remained consistently low at 1%-2% for the subsequent nine quarters.

Conclusions:

  • A comprehensive, multidisciplinary approach is effective in significantly reducing and maintaining low rates of HAPU.
  • Sustained low HAPU incidence is achievable through ongoing monitoring, strategic interventions, and staff education.
  • The UMH program demonstrates a successful model for improving patient safety regarding pressure ulcers.