The Pressure Is On! An Innovative Approach to Address Pressure Ulcers in the ED Setting

Abstract

An overlooked area in pressure ulcer development has been the emergency department, which is frequently the point of entry for patients who require hospitalization. The risks associated with pressure ulcer prevention are not considered a priority to be addressed in the emergency department. 1 Spahn J Pressure ulcer dilemma in the emergency department environment. http://www.ehob.com/pdf/seamless/ulcers-er.pdf Google Scholar However, patients often remain in the emergency department for hours. 1 Spahn J Pressure ulcer dilemma in the emergency department environment. http://www.ehob.com/pdf/seamless/ulcers-er.pdf Google Scholar , 2 Lucas R Farley H Twanmoh J Urumov A Evans B Olsen N Measuring the opportunity loss of time spent boarding admitted patients in the emergency department: a multihospital analysis. J Healthcare Manage. 2009; 54: 117-124 PubMed Google Scholar Most mattress surfaces in the emergency department are designed for transport or short-term use. Patients who remain on these surfaces are at risk for the development of pressure ulcers. A pressure ulcer can develop in two hours if precautions are not implemented. 1 Spahn J Pressure ulcer dilemma in the emergency department environment. http://www.ehob.com/pdf/seamless/ulcers-er.pdf Google Scholar This situation presents an opportunity for early identification and intervention for patients at risk. 3 van Rijswijk L Lyder C Pressure ulcers: were they there on admission?. Am J Nurs. 2008; 108: 27-28 Crossref PubMed Google Scholar , 4 Denby A Rowlands A Stop them at the door: should a pressure ulcer prevention protocol be implemented in the emergency department?. JWound Ostomy Continence Nurs. 2010; 37: 35-38 Crossref PubMed Scopus (27) Google Scholar This article will provide the reader with examples of tools used at two Sutter Health facilities to identify skin issues and prevent pressure ulcers in the emergency department. Sutter Health is a not-for-profit organization with 23 affiliated hospitals plus physician care centers serving patients and their families in more than 100 Northern California cities and towns. Linda Bjorklund is Risk Management Consultant, Sutter Health, Sacramento, CA. Alice Basch is Wound/Ostomy Nurse Specialist, Marin General Hospital, Greenbrae, CA. Betsy Borregard is Director, Nursing Education & Clinical Effectiveness, Marin General Hospital, Greenbrae, CA. Beth Brown is Director of Emergency Services, Respiratory Therapy and Rural Health, Sutter Coast Hospital, Crescent City, CA. Jennifer Denno is Clinical Nurse Educator, Emergency Department, Sutter Medical Center, Sacramento, CA. Emy Montgomery is Manager Accreditation, Licensure and Risk Management, Sutter Medical Center, Santa Rosa, CA. Kathryn Pedicini is Nursing Manager, Emergency Services, Sutter Auburn Faith Hospital, Auburn, CA. Jo Saporito is Manager, Integrated Quality Services, Sutter Solano Medical Center, Vallejo, CA.