Byers, Stephanie, BSN, RN

Carruthers, Isla, BSN, RN

Ni, Kim, BSN, RN

Thomson, Laura, BSN, RN

Wunder, Kailyn, BSN, RN

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksPatient Care Services / NursingTurn Over for What: Pressure Injury Preventionand Nurse/Technical Partner Compliance.Kim Ni BSN, RNLehigh Valley Health Network, Kim.Ni@lvhn.orgStephanie Byers BSN, RNLehigh Valley Health Network, Stephanie.Byers@lvhn.orgLaura Thomson BSN, RNLehigh Valley Health Network, Laura_K.Thomson@lvhn.orgKailyn Wunder BSN, RNLehigh Valley Health Network, Kailyn_E.Wunder@lvhn.orgIsla Carruthers BSN, RNLehigh Valley Health Network, Isla_C.Carruthers@lvhn.orgFollow this and additional works at: https://scholarlyworks.lvhn.org/patient-care-services-nursingPart of the Nursing CommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtNi, K. Byers, S. Thomson, L. Wunder, K. Carruthers, I. (2018, February 9). Turn Over for What: Pressure Injury Prevention and Nurse/Technical Partner Compliance. Poster Presented at: LVHN Vizient/AACN Nurse Residency Program Graduation, Lehigh Valley HealthNetwork, Allentown, PA.© 2014 Lehigh Valley Health NetworkLehigh Valley Health Network, Allentown, PennsylvaniaTurn Over for What: Pressure Injury Prevention and Nurse/Technical Partner Compliance• There is an opportunity to improve nurse sensitive quality indicators related to pressure injuries.• Unit acquired pressure injury developmentThe Number of Pressure Injuries on Each Unit• Monitoring demonstrated repositioning is done less frequently than the recommended Q2 hours.• Pressure injury development is associated with increased costs to the network. • Pressure injuries account for $11billion in annual health care spending in the US. ³• Turning and repositioning is fundamental to pressure injury prevention. ³• Having a visual aide helps nurses and technical partners consistently turn patients. ²• Pressure injury development can have a negative impact on a patient’s quality of life. 4• Evidence showed that nurses relied on techs to turn patients within 30 minutes of a scheduled time. ¹ • Turning sensor reminded nurses and techs to turn patients. ² Magnet- 6K No visual cue- others0%10%20%30%40%50%60%70%80%90%100%Percentage of ComplianceMedical Surgical Nurse and Technical Partner compliance with turningPre DataPost DataIn licensed and non-licensed staff on medical-surgical patient care units, does use of a  visual cue versus no repositioning prompts improve compliance in turning patients with a Braden score of 18 or less at risk for pressure injury development?• P- Licensed and non-licensed staff on med-surg units• I- Using a visual prompt• C- No repositioning prompts• O- Improve compliance with turning at risk patients with Braden scores 18 or lessTurning Magnet1. Bergstrom, N., Horn, S. D., Rapp, M. P., Stern, A., Barrett, R., & Watkiss, M. (2013). Turning for ulcer reduction: A multisite randomized clinical trial in nursing homes. Journal of the American geriatrics society, 61(10), 1705-1713.2. Do, N. H., Kim, D. Y., Kim, J. H., CHoi, J. H., Joo, S. Y., KaNg, N. K., & BaeK, Y. S. (2016). Effects of a continuous lateral turning device on pressure relief. Journal of physical therapy science, 28(2), 460-463. Gillespie, B. M., Chaboyer, W. P., McInnes, E., Kent, B., Whitty, J. A., & Thalib, L. (2012). Repositioning for pressure ulcer prevention in adults. Cochrane Database SystRev20144Cd009958.4. Moore, Z. E., & Cowman, S. (2012). Repositioning for treating pressure ulcers. Cochrane Database Syst Rev, 9.Kim Ni BSN, RN; Stephanie Byers BSN, RN; Laura Thomson BSN, RN; Kailyn Wunder  BSN, RN; Isla Carruthers BSN, RNBackgroundPICOEvidence Monitoring ResultsReferenceOutcomes:• Improved compliance of turning.• Staff stated magnets helped  with compliance of turning and repositioning. However, some staff stated that the specific timing of magnet was not for every patient.Long term goals and outcomes:• Proposal to Skin Integrity Quality Improvement Team & unit skin champions• Promote patient safety• Decrease costs for the network • Improve patient outcomesImplementation Plan• Secret shopper repositioning audits were preformed on patients who required repositioning. Secret shoppers included PCS from unit during day shift, and nurse residents during night shifts for 4 shifts.• During safety huddle or through use of Epic report, determine the patients who have a Braden score of 18 or less (exclude patients who refused repositioning).• Implementation of turning clock as a visual cue on 6K; other units were control units-6T, 6C use individual nurse timed turning; 4K uses even and odd hour turning.• Following magnet implementation, repeat monitoring related to compliance of turning during night shift for 4 shifts.• Qualitative data- surveys were provided to staff on 6K to obtain feedback on use of magnets.Unit Sept 2017 Oct 2017 Nov 20176T 0 1 16K 1 0 24K 1 3 26C 3 1 0

Turn Over for What: Pressure Injury Prevention and Nurse/Technical Partner Compliance.

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=1942&context=patient-care-services-nursing

Turn Over for What: Pressure Injury Prevention and Nurse/Technical Partner Compliance.

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Lehigh Valley Health Network: LVHN Scholarly Works