1. Initiative Update & Data Analysis

2. Themes for the Day Lessons Learned and Best Practices Staging of Pressure Ulcers Care Coordination

3. Accomplishments 80 facilities and agencies and over 446 participants involved in initiative Story Board Examples What is occurring day-to-day in our facilities/agencies

4. Accomplishments During a recent discussion it was the aide that identified that the foot pedals were not always used. This changed the pressure to the buttocks resulting in a pressure area. The director was very proud of that staff and shared how front line staff is the cornerstone in her fight against pressure ulcers.

5. Accomplishments A Director of Nursing recently stated the focus on the CNAs and facility service personnel as critical team members is providing them important information for clinical decision-making. She reported many of the CNAs were excited to have responsibility for care suggestions and decisions. By offering Saturday care plan meetings, a facility has increased family participation

6. Accomplishments A facility posted the IPUQII commitment board in the entry hallway upon returning from their first learning session. After explaining the initiative to a resident meeting the residents wanted to sign the board along side of the staff.

7. Data Summary What is the data telling us? How are we going to use this data to improve our pressure ulcer systems? How are we going to use this data to improve our care coordination?

8. Data Analysis

9. Knowledge summary by group

10. Knowledge summary Most Frequently Missed Questions % with Incorrect Response % with Correct Response Who should be actively involved in reduction of patient’s pressure ulcer? 32.068.0 Sites most susceptible to pressure ulcer development?36.663.4 How long does it take for a pressure to form?38.261.8 A daily bath or sponge bath will prevent pressure ulcers.46.054.0 Donut devices or ring cushions help prevent pressure ulcers.66.533.5 Massaging a bony prominence (area) promotes circulation and prevents pressure ulcers. 66.533.5

11. Self assessment summary Performs a comprehensive pressure ulcer risk assessment within first 24 hours of admission. ResponsePercent of facilities Home health (N=12) Hospital (N=4) Long term care (N=47) Always41.7 %50.0 %66.0 % Frequently0.0 %50.0 %25.5 % Seldom8.3 %0.0 % Never50.0 %0.0 %2.1 % Missing0.0 % 6.4 % q1-q1-q1

12. Self assessment summary Implements designated interventions that correlate with identified risk factors after admission risk assessments are performed. ResponsePercent of facilities Home health (N=12) Hospital (N=4) Long term care (N=47) Always8.3 %25.0 %34.0 % Frequently25.0 %75.0 %61.7 % Seldom8.3 %0.0 %4.3 % Never58.3 %0.0 % Missing0.0 % q3-q3-q3

13. Self assessment summary Communicates results of both risk and routine skin assessments to appropriate staff. ResponsePercent of facilities Home health (N=12) Hospital (N=4) Long term care (N=47) Always33.3 %0.0 %21.3 % Frequently50.0 %25.0 %55.3 % Seldom0.0 %75.0 %12.8 % Never41.7 %0.0 %2.1 % Missing0.0 % 4.3 % q6-q6-q7

14. Self assessment summary Provides pressure ulcer prevention training as part of the orientation process. ResponsePercent of facilities Home health (N=12) Hospital (N=4) Long term care (N=47) Always16.7 %0.0 %34.0 % Frequently8.3 %0.0 %23.4 % Seldom16.7 %50.0 %19.1 % Never58.3 %50.0 %19.1 % Missing0.0 % 4.3 % q8-q8-q9

15. Self assessment summary Tracks patients with both nosocomial pressure ulcers and those admitted with pressure ulcers. ResponsePercent of facilities Home health (N=12) Hospital (N=4) Long term care (N=47) Always41.7 %0.0 %97.9 % Frequently0.0 %50.0 %2.1 % Seldom16.7 %50.0 %0.0 % Never41.7 %0.0 % Missing0.0 % q15-q15-q18

16. Self assessment summary Use a multi-disciplinary team approach to pressure ulcer prevention? ResponsePercent of facilities Home health (N=12) Hospital (N=4) Long term care (N=47) Yes50.0 %75.0 %85.1 % No50.0 %25.0 %12.8 % Missing0.0 % 2.1 % q17-q17-q20

17. Self assessment summary Have at least one nurse who has specialized training in wound care and management? ResponsePercent of facilities Home health (N=12) Hospital (N=4) Long term care (N=47) Yes50.0 %75.0 %70.2 % No50.0 %25.0 %27.7 % Missing0.0 % 2.1 % q18-q18-q21

18. Self assessment summary Have one or two designated nurses who measure and document on all wounds consistently? ResponsePercent of facilities Home health (N=12) Hospital (N=4) Long term care (N=47) Yes16.7 %25.0 %85.1 % No83.3 %75.0 %14.9 % Missing0.0 % q19-q19-q22