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Assess all patients to prevent pressure ulcers

Quality Improvement Monitor, June 6, 2008

Heightened awareness, new beds that provide pressure relief, and skin assessments on every patient entering the facility helped Baystate Medical Center in Springfield, MA, reduce its pressure ulcer rate from 20% to 0.8%.

The push to improve the rate for bedsores started in the mid-1990s, when one of the directors came to the hospital and said, “We can do better than this,” says Jan Fitzgerald, MS, RN, director of quality and medical management for the division of healthcare quality at Baystate. To accomplish that, the 670-bed hospital:

  • Purchased state-of-the-art beds with pressure relief/reduction capabilities for all nursing units
  • Reviewed the literature and customized and adopted skin protocols based on guidelines of the Agency for Healthcare Research and Quality
  • Launched a skin resource committee with unit-based representation
  • Adopted the Braden risk-assessment tool that is used on admission and 48 hours after admission
  • Invested in certified wound-care nurses
  • Conducted quarterly prevalence studies, which were posted on the units

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