Nurses Step Up Their Skin Care Knowledge to Prevent Pressure Ulcers

Skin Care Team
Photos by David Christopher

Left to right: Ann Nelson, APN, BC, ANCP, tries her hand at “Operation” as Skin and Wound Care Team nurses Marianne Banas, RN, and Jennifer Sala, RN, observe. The game was part of an illustration of how to take width and length measurements of wounds in patients. The activity was part of the Skin and Wound Education Fair, an educational event organized by the Skin and Wound Care Team in October.

Chris Baker
Chris Baker, RN, CWOCN, describes the various stages of a pressure ulcer using visual aids she created in her home.
By Jennifer Martin

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 gangrene.

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 solution.

“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 occur.”

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.”