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H - Skin Integrity

Roadmap: Optimal Pressure Ulcer Prevention and Management Healthcare policy relating to pressure ulcer prevention and management is urgently required. This process must begin with coordinated messaging directed at federal/provincial/regional governments, health authorities and funding agencies, from advocacy groups (APF, Canadian Paraplegic Association (CPA), Canadian Spinal Research Organization (CSRO), local health authorities, Ontario Neurotrauma Foundation (ONF), Rick Hansen Institute (RHI), Rick Hansen Foundation (RHF), Solutions Alliance and others). Awareness can be immediately leveraged through the planned and legacy activities of the RHF 25th Anniversary Campaign. In addition, frontline clinicians and researchers can begin to improve pressure ulcer prevention and management practices through BPI, and by moving towards establishing centres of excellence, through Accreditation Canada (AC) BPI or performance measures (PM). Table 1.0 Accreditation Canada Compliance Test Accreditation Canada 2011 (February) BPIs also identified the folowing tests for compliance How is it measured? Who measures it? Where? When is it idealy measured? 1. The organization conducts an initial pressure ulcer risk assessment at admission, using a standardized riskassessment tool. Counts** Program* Quarterly 2. At regular intervals, the organization reassesses each client for risk of developing pressure ulcers. Counts Program* Quarterly 3. The organization implements documented protocols and procedures to prevent the development of pressure ulcers. These include interventions to prevent skin breakdown and reduce pressure, as well as those that focus on repositioning, managing moisture, maximizing nutrition, and enhancing mobility and activity. Counts Program Quarterly 4. The organization educates staff on risk factors and strategies for the prevention of pressure ulcers. Counts Program* Quarterly 5. The organization monitors its success in preventing the development of pressure ulcers, and makes improvements to its prevention strategies and processes. Pressure Ulcer Incidence/ Prevalence Program* Quarterly ** Counts – To name or list the units of a group or frequency of date/event, one by one, in order to determine the total. * Program – Within the local participating SCI rehabilitation programs. TABLE 2.0 RHI, ONF, APF and KMN activities on BPIs in SCI presure ulcers to inform Accreditation Canada standards RHI, ONF, APF and KMN BPIs and PMs (as of 2011/07/23) For presure-ulcer prevention in SCI How is it measured? Who measures it? Where? When is it idealy measured? 1. Overall, SCI pressure ulcer prevention and management program PMs are evaluated by: • The percentage of designated staff who have completed Continuing Medical Education (as appropriate for each implementation target) pertaining to pressure ulcer risk assessment, and structured and individualized education methods; and report completion of orientation and annual continuing medical education (CME) thereafter • The percentage of designated staff with demonstrated competence in performing pressure ulcer risk assessment, and conducting structured and individualized education. Counts Program Annual 2. SCI pressure ulcer risk assessment best practice PMs are evaluated by: • The percentage of individuals with a documented review of their pressure ulcer risk assessment (conducted at regular intervals and when they’ve experienced a change in status) • The percentage of individuals who indicate that they have been informed of the results of their pressure ulcer risk assessment. Counts Program Annual 3. SCI pressure ulcer education best practice PMs are evaluated by: • The percentage of individuals who report scores ≥ 7/10 (on a Likert scale where 0 = disagree; 10 = agree), to indicate that a structured and individualized education program provided adequate education regarding pressure ulcer prevention and management strategies. Counts Program Annual Anticipated Results of BPI and AC Distinction If a presure ulcer prevention and management healthcare policy plat form were established to facilitate BPI and AC Distinction adherence, the folowing results are anticipated : • Standardized and consistent best practices, across the continuum of care • Improved quality of life for all individuals, including those living in the community • Precursor to individual self-management • Decreased healthcare costs • Increased economic contribution by individuals with SCI, in the community. SKIN INTEGRITY | BODY STRUCTURE AND FNUCTION 91


H - Skin Integrity
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