Integration of the aSSKINg framework into the electronic patient record: a quality improvement project

Area of Science:

• Nursing
• Clinical Informatics
• Quality Improvement

Background:

• Accurate pressure ulcer (PU) risk assessment and documentation are crucial in clinical practice.
• Despite guidelines, nursing documentation for PU risk remains inconsistent.
• Previous studies established the evidence for PU prevention bundles and audited compliance in community settings.

Purpose of the Study:

• To enhance nursing documentation of PU risk by implementing the aSSKINg framework into an electronic patient record (EPR).
• To evaluate the impact of EPR integration on adherence to the aSSKINg framework for PU prevention.

Main Methods:

• A quality improvement project involving a clinical audit.
• Implementation of the aSSKINg framework template into the EPR.
• Two-part audit: pilot phase (Feb-Apr 2023) and follow-up audit (Nov 2023-Jan 2024).
• Phased rollout to adult community nursing, care home matrons, and urgent community response teams post-pilot.

Main Results:

• Overall compliance with the aSSKINg framework significantly improved post-EPR implementation.
• Key improvements noted in the completion of PURPOSE-T on first visit, full skin assessment, and repositioning advice.
• The EPR template facilitated better documentation across various community nursing teams.

Conclusions:

• Integrating the aSSKINg framework into the EPR is an effective strategy to improve nursing documentation for PU risk.
• Enhanced documentation supports better adherence to PU prevention guidelines.
• This quality improvement initiative demonstrates the value of clinical informatics in patient safety.