By Jennifer Martin
|Chris Baker, RN, CWOCN, describes the various stages of a pressure ulcer using visual aids she created in her home.|
Pressure ulcers have been attracting increased attention from medical
professionals in recent years because they are recognized as a serious
threat to hospital inpatients. These skin lesions sometimes form when a
patient stays in bed for an extended period of time, particularly if he
or she is unable to move. As havens for bacteria, the ulcers can grow
quickly and lead to complications such as anemia, sepsis and even
Caregivers and medical staff at the University of Chicago Medical Center
are trained to do as much as possible to prevent pressure ulcers from
forming. The Skin and Wound Care Team was designed to be part of the
“We have many resources available to give the best protection we can,”
said Chris Baker, RN, CWOCN, who codirects the Skin and Wound Care Team with
Noreen Reaney, RN, CWON.
The Skin and Wound Care Team is composed of nurses from each hospital unit in both
Bernard A. Mitchell Hospital and Comer Children’s Hospital at the University of
Chicago. The 44 nurses commit to quarterly training sessions in
preventing and treating pressure ulcers as well as other types of
wounds. They take the knowledge back to their units, sharing information
with other nurses and caregivers.
“We would like the nurses to be sort of a skin care champion for their unit,” Baker explained.
The nurses learn, among other things, which patients are more vulnerable
to pressure ulcers: those who are older, incontinent or taking certain
medications, for example.
“Pressure ulcers cannot always be prevented,” Baker said. “But we do
have many interventions to decrease the likelihood that they will
Among those interventions are rotating the patient every two hours,
keeping the skin moisturized, using protective coverings to reduce skin
friction, applying protective barrier ointments and sometimes giving the
patient nutritional supplements.
The nurses also learn how to spot the early signs of a pressure ulcer so that they can intervene quickly.
Recently, eight members of the team conducted a six-month pilot project
in which they committed to 16 hours per month of patient rounding and
staff education in the ICUs. After the pilot was completed,
hospital-acquired pressure ulcer rates dropped in the Intensive
Care Unit and hospitalwide.
“We saw a significant increase in the documentation of wound
assessments, as well as improved documentation of pressure ulcer
interventions,” Baker said.
The project won an award at the Medical Center’s annual Quality Fair in October.
To Baker, the project was one of many signs that the Skin and Wound Care
Team is improving patient care hospitalwide. “We’re trying to empower
the Skin and Wound Care Team to promote staff education,” Baker said.
“Ultimately, our goal is to improve patient outcomes.”