Protecting skin integrity in the acute healthcare environment

Background: This project built on the previously successful Champions for Skin Integrity study that included evidence-based implementation strategies and developed wound care resources for the implementation of evidence based wound care in residential aged care facilities.Purpose: We know that many older adults in acute and subacute health services also suffer with loss of skin integrity, leading to chronic wounds and prolonged ill-health. This further project investigated strategies to facilitate uptake of best practice in prevention and management of wounds by evaluating the implementation of a program (Protecting Skin Integrity (PSI)) in asample of Queensland Health acute, subacute, transition and aged care services.Methods: A pre/post implementation study was undertaken. The program was based on evidence-based strategies for knowledge translation, including ‘train-the-trainer’ workshops, goal setting, audit and feedback cycles and local education and clinical workshops. A multi-faceted evaluation was undertaken, including staff surveys, interviews, and patient skin integrity assessments prior to, and six months after, the implementation of the PSI model.Results: Patient skin surveys found a significantly decreased point prevalence of wounds (e.g., pressure injuries decreased from 15% to 5%, skin tears from 24% to 13%); and increased uptake of evidence-based skin and wound management; Staff confidence in knowledge of evidence-based prevention, assessment and management of wounds significantly increased.Conclusions: This study demonstrated that evidence-based strategies for knowledge translation are able to promote uptake of best practice and lead to decreased prevalence of wounds and improved staff confidence of wound care in acute and subacute health areas as has previously been shown in residential aged care