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APHA Scientific Session and Event Listing

Recorded presentation

Consuelo U. Dungca, EdD, RN, New York City Health and Hospitals Corporation, 125 Worth St, Suite 427, New York, NY 10013, 212-788-3397, Consuelo.Dungca@nychhc.org and Juliet G. Gaengan, RN, MSA, NYC Health and Hospitals Corporation, 125 Worth Street, Suite 427, New York, NY 10013.

NYC Health & Hospitals Corporation (HHC) is a public health benefit with 11 hospitals, 4 long term care, 6 diagnostic and treatment centers, a health and home care and a managed care agencies. HHC provides health care services to a largely disadvantaged, multicultural and multiethnic population, with variety of chronic diseases and little attention to preventative care. Scientific and evidence based studies have shown that Quality Improvement (QI) process has made significant impact on developing/implementing Best Practice guidelines. Pressure ulcers are associated with significant increase in patient's length of stay, hospital costs and 3% of total US healthcare costs ($3 to $7 billion annually). It is also estimated that 60,000 deaths annually are related to pressure ulcers (Kloth, 2002) that could be prevented. While price cannot be placed on the cost of human suffering, pressure ulcers account for approximately 17,000 litigation cases annually in the US with individual awards as high as $4 million dollars. Recognizing the importance of pressure ulcer prevention, the HHC Quality Assurance Committee (QAC) of the Board of Directors identified this as one of several opportunities to improve care. The QAC formed a task force with representatives from five long term care facilities and 11 hospitals to identify preventative measures, maintain skin integrity and reduce incidence of pressure ulcers. Implementation of evidence based best practice in conjunction with Quality Improvement measurement processes, and methodologies was established as the goal. HHC Corporate-wide Pressure Ulcer Guidelines was implemented as a result of a multidisciplinary Task Force who researched and developed evidenced based practices captured in these Guidelines. Baseline data from each facility on pressure ulcer incidents have been established before implementation of the guidelines in December 2005. Results at the end of the year will be compared to the baseline data. The Task Force will continue to address present and future issues as the guidelines are implemented as well as opportunities for improvement. A quality improvement approach on prevention and improving management of pressure ulcers requires a high level of commitment from the Governing Body, Administration and “hands-on” staff. It is imperative that healthcare facilities recognize that patients/ residents admitted without pressure ulcers maintain their skin integrity and not develop pressure ulcer(s) unless clinically unavoidable. In addition, patients/residents with pressure ulcer must receive care to promote healing using evidence based practice.

Learning Objectives: