Module 4: How To Implement the Pressure Injury Prevention Program in Your Organization

Slide Presentation

Slide 1: How To Implement the Pressure Injury Prevention Program in Your Organization

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ADD Hospital Name here

Module 4

Slide 2: What We Have Done Thus Far

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  • Up to this point, you have:
    • Looked at your organization’s readiness to improve pressure injury prevention (Module 1).
    • Examined current practices and identified aspects needing improvement (Module 2).
    • Examined best practices and made preliminary decisions on what best practices will be included in your Pressure Injury Prevention Program (Module 3).

Slide 3: Following Best Practice

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  • The Implementation Team will work with the Unit Teams and Wound Care Team to implement the new prevention practices.

Image: Photograph shows medical providers looking at a tablet.

Slide 4: Implementation Planning Goals

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  • Determine the roles and responsibilities of staff in preventing pressure injuries.
    • What role will the Unit Team and Wound Care Team play?
    • What role will the Unit Champions play? 
    • When will they be oriented and integrated into the implementation process?
    • How should prevention work be organized at the unit level?

Slide 5: Planning Goals

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  • Plan how you will:
    • Put best practices into operation.
    • Manage the change process on patient care units.
    • Pilot test the new best practices.

Slide 6: Planning Goals

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  • Plan how you will:
    • Get staff engaged and excited about pressure injury prevention.
    • Educate staff on new best practices.

Image: Photograph shows medical providers holding a meeting.

Slide 7: Staff Roles

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  • Assign staff to perform each specific task in your set of best practices, based on training and experience.

Images: Two photographs show medical providers consulting papers and looking at a computer monitor.

Slide 8: Staff Roles

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  • In some cases, a group will perform the task based on specific roles, such as a group of certified nursing assistants.
  • Other tasks may be assigned to a specific person.
    • In that case, be sure to assign a backup person.

Image: Photograph shows a medical provider assisting a patient with a mobility device.

Slide 9: List of Best Practices

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  • Preliminary list of best practices.

Images: An example table for listing best practices and assigning who is responsible for each is shown. An icon of a magnifying glass in front of open book identifies this as Tool 4A.

Slide 10: Staff Roles

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Images: Two photographs show medical providers looking at a tablet, and a medical provider standing at a patient’s bedside.

Slide 11: Staff Roles

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  • Examples of how responsibilities may be assigned.

Images: Two screenshots show a sample table assigning roles to staff members. An icon of a magnifying glass in front of open book identifies this as Tool 4B.

Slide 12: Staff Roles

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  • Using Tool 4B, think about how you may want to divide responsibilities.
    • Members of the Unit Team.
    • Hospital staff members whose work brings them to the unit or includes interacting with the unit.
  • Consider forming a small Task Force.
  • Appoint a Task Force Team Lead, and ask for volunteers to work on this task.

Slide 13: Wound Care Team Role

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  • Serves as this hospital’s content experts on pressure injury prevention.
  • Has experts and resources in current wound care practice.
  • May be a formal or informal department, or an individual clinician.

Slide 14: Unit Team Role

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  • Staff members who provide daily direct patient care by:
    • Conducting skin assessments.
    • Conducting pressure injury risk assessments.
    • Planning care for risk prevention.
    • Ensuring care is performed and documented.

Image: Photograph shows two providers looking at a computer.

Slide 15: Unit Team

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  • The Unit Team works collaboratively with the Wound Care Team.
    • Unit staff tell the Wound Care Team about high-risk patients or if skin problems occur.

Image: Photograph shows medical providers having a discussion. An icon of a magnifying glass in front of open book refers to Pages 59-61.

Slide 16: Unit Team

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  • Make sure you include a written plan for orienting and monitoring temporary staff.

Image: Photograph shows medical providers looking inside a folder.

Slide 17: Unit Champion

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  • Staff member who serves as the liaison between the Implementation Team, the Wound Care Team, and the Unit Team.
  • Most familiar with the program goals, care processes, and outcome data to be used.
  • Critical during the implementation process (may be temporary).
  • Ideally, one champion per shift, per unit.

Image: Photograph shows a medical provider holding a tablet.

Slide 18: Practice Insight

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  • Hospital leadership supported:
    • Save Our Skin Unit Champion 4-hour boot camp.
      • Key result: 40% knowledge increase.
    • Bimonthly Unit Champion pressure injury prevention/ wound care lunch and learn sessions.

Images: Icon of binoculars. Photograph of a flotation device with the logo "To the Rescue … Save our Skin".

Slide 19: Staff Turnover

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All hospitals experience the challenges of staff turnover.

Image: Photograph shows medical providers at a patient’s bedside.

Slide 20: Practice Insight

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Staff Turnover

Images: Three photographs show medical providers at in-person training, looking at a computer screen, and clapping at a meeting.

Slide 21: Communication Patterns

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  • Good communication needs to occur among staff at all levels.
    • Within the unit (among nurses, nurse assistants, physicians, and patients and their families).
    • Among unit staff, the Implementation Team, the Wound Care Team, and senior management.

Images: Three photographs show medical providers at a patient’s bedside, a leader and medical providers having a discussion, and two medical providers looking at papers.

Slide 22: Communication Patterns

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  • Communicate how changes are actually happening.
  • Unit Champions can present updates on implementation at regularly scheduled meetings.
    • This can be done thoroughly and succinctly with the least amount of time and effort.

Slide 23: Integrate Prevention Into Ongoing Processes

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  • Necessary for sustainability.
  • Integrated into regular communications (e.g., shift handoffs).
    • Make certain procedures (such as skin assessments) universal so staff do not have to decide which patients they apply to.
    • Ensure nurses have access to supplies.       
    • Create visual cues/logos (turning clocks to remind staff when repositioning is due).
    • Other examples?

Images: A photograph shows medical providers looking at tablets. An icon of a magnifying glass in front of open book refers to Page 65.

Slide 24: Electronic Health Record Opportunities

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  • What information about pressure injury risk factors is already part of the patient record?
  • What is the most logical place in the record to collect, organize, and assess information about patient pressure injury risk factors and any necessary precautions?
  • Additional suggestions?

Images: A photograph shows medical providers looking at tablets. An icon of a magnifying glass in front of open book refers to Page 66.

Slide 25: Manage the Change Process

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  • Ensure staff understand new roles.
  • Ensure staff understand reasons for change and agree change is needed.
  • Convey that pressure injury prevention is part of high-quality care and is valued by all, including senior hospital leadership.

Slide 26: Manage the Change Process

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  • Have adequate access to supplies:
    • Dressings.
    • Skin creams.
  • Engage staff to gain support and buy-in to tailor new practices.
  • Encourage staff to speak up if supplies and equipment are lacking, missing, or broken.

Image: Two photographd show medical providers conducting an inventory and applying skin cream to a patient's hand.

Slide 27: Monitor Implementation Progress

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  • Baseline measures of pressure injury rates and processes should be obtained before any change.
  • Tracking care processes to prevent pressure injury is a measure of implementation success and should translate to better outcomes.
  • Outcome measures: track changes in pressure injury rates.
  • Inform the Implementation Team and staff about results.

Slide 28: Monitor Implementation Progress

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  • Close the loop.
  • Have the Implementation Team report to the unit what it did with the information the unit provided.

Images: Two photographs show medical providers looking at papers and looking at a tablet.

Slide 29: Communicate Success

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  • Methods for sharing updates and information on successes from prevention activities to the rest of the hospital include:
    • Posters with results in the units or lunchroom.
    • Newsletter articles.
    • Email blasts.
    • Announcements on the hospital’s Web page.
    • Discussions during staff meetings.

Slide 30: Sustain Pressure Injury Prevention

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  • Close the information loop. Inform senior leaders and middle managers about progress.
  • Keep clinical staff informed about progress with pressure injury prevention.

Image: Photograph shows leaders and medical providers having a meeting.

Slide 31: Staff Education and Training

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  • Develop an education plan.
    • Adults learn best through experiential activities.
  • Don’t forget prevention education for the patient and family members and significant others.

Image: An icon of a magnifying glass in front of open book sits beside the text "See Tool 3G: Patient and Family Education."

Slide 32: Staff Education and Training

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  • You can use a variety of educational approaches, such as didactic methods (e.g., lectures and interactive presentations).

Image: Two photographs show staff members at in-person training and virtual training.

Slide 33: Practice Insight

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  • Problem: assessment/care plan/documentation.
  • Staff Education: RN, CEO, CNO, PCT.
    • 2-hour didactic competency training: 
      • Braden risk assessment and patient comorbidity review.
      • 5 in 5 Visual Assessment Tool for pressure injuries.
      • Many visuals of actual patients.
      • Appropriate interventions based on risk – review of all products.
      • How to document implementation and maintenance of plan.
    • 1-hour hands-on skills lab – 3 scenarios.
  • Key results:
    • Assessment/care planning accuracy improved from 50% to 90%.
    • Continued issue with documentation.

Image: Icon of binoculars.

Slide 34: Group Activity: Assess Staff Education

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  • Assess current staff education.
  • Assess educational needs.

Images: A screenshot shows a sample Facility Assessment tool. An icon of a magnifying glass in front of open book identifies this as Tool 4C.

Slide 35: Staff Knowledge Assessment

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Image: Photograph shows hospital staff taking knowledge assessment.. An icon of a magnifying glass in front of open book refers to Tool 2G: Pieper Pressure Ulcer Knowledge Test.

Slide 36: Staff Education and Training

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  • Regular/ongoing education means including pressure injury prevention in four areas of training:
    • Annual education for all staff.
    • Staff competencies.
    • New staff orientation.
    • Training of temporary staff.

Image: Photograph shows staff members at training.

Slide 37: Practice Insight

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Images: Icon of binoculars. A screenshot shows the Pressure Ulcer Prevention Program Action Plan: June 2015 - January 2016. Key Interventions 3 and 4 are circled in red.

Slide 38: Action Plan

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Action Steps for Key Interventions 3 and 4

Images: A screenshot shows a sample Action Plan with Key Interventions 3 and 4 circled in red. An icon of a magnifying glass in front of open book sits above the text "Refer to your Action Plan."

Slide 39: Summary

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  • To summarize, we addressed the following:
    • Roles and responsibilities of the Unit Team,.
      Wound Care Team, and Implementation Team in preventing pressure injuries.
    • Importance of the Unit Champions.
    • Communication during implementation.
    • Staff training needs to learn new practices.
    • Action Plan for putting the prevention program into practice.
Page last reviewed October 2017
Page originally created September 2017
Internet Citation: Module 4: How To Implement the Pressure Injury Prevention Program in Your Organization. Content last reviewed October 2017. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/professionals/systems/hospital/pressureinjurypxtraining/workshop/module4/mod4-slides.html
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