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Marlyn Conti , BSN, MM, CPHQ Patient Safety Initiatives Manager Intermountain Healthcare

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Intermountain-led CMS Hospital Engagement Network Pressure Ulcer Prevention June 24, 2014 Affinity Call. Marlyn Conti , BSN, MM, CPHQ Patient Safety Initiatives Manager Intermountain Healthcare. Outline for Discussion. Review of the HEN Pressure Ulcer work

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Intermountain-led CMS Hospital Engagement Network Pressure Ulcer PreventionJune 24, 2014 Affinity Call

Marlyn Conti , BSN, MM, CPHQ

Patient Safety Initiatives Manager

Intermountain Healthcare

outline for discussion
Outline for Discussion
  • Review of the HEN Pressure Ulcer work
  • “Just-one-thing” Recommendations
  • High performers
  • 2014 plans for improvement:
high performing hospital highlight
High Performing Hospital Highlight…

Pressure Ulcers >= Stage 3

high performing hospital highlight1
High Performing Hospital Highlight…

Pressure Ulcers >= Stage 2

  • *Most Improvement
    • Only 2 Hospitals have

Reported Q1 2012 and

Q 1 2014 data

high performing hospital highlight2
High Performing Hospital Highlight…

Pressure Ulcers Prevalence – All stages

practice survey
Practice Survey
  • Do you have a pressure ulcer prevention team? Yes/No
    • If yes, Is your team multidisciplinary? Yes/No
    • If yes, how frequently do they meet?
    • Do they have resources to collect/interpret/review data?
      • Comments (free text)
  • What tools do you use to assess and properly stage a pressure ulcers? (free text)
    • Posters, fact sheets, etc, other (free text)
practice survey1
Practice Survey
  • Do you have skin and/or pressure ulcer assessment prompts embedded in your EMR? Yes/No
    • If yes, how often are they reported or prompted
      • Who receives the reports
      • What are the expected actions
    • To determine if reassessing patients at established frequencies
  • What is the one intervention that has had the most impact in reducing pressure ulcers? (free text)
  • What is the most innovative approach to reducing pressure ulcers?
pressure ulcer scenario
Pressure Ulcer Scenario

9 M/O female infant with congenital anomalies requiring tracheostomy with an un-cuffed trachplaced.  Secretions were very difficult to manage and the MD indicated that re-intubation would be ‘impossible’ for this baby. 

Trachties were very tight in order to hold the tube in place.

The first trach change was performed 7 days after the initial placement and a stage IV pressure ulcer was found from the trach ties.

What could have been done??

pressure ulcer scenario1
Pressure Ulcer Scenario

40 Y/O male, admitted with altered level of consciousness related to hepatic encephalopathy, hypotension and abdominal ascites. Patient had several large volume paracentesisperformed with rapid re-accumulation of fluid.

The decision was made by the physician and the patient\'s mother to provide comfort measures only and the patient was transferred to inpatient hospice. 4 days after hospice transfer, a stage III pressure ulcer was found on his coccyx.

  • What this preventable?
  • What would you have done??
2014 plans for improvement
2014 plans for improvement
  • Collect and share best practices across our network hospitals & system in a single document
  • Share practice bundles?
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