We need to implement a pressure injury prevention and treatment program. I’m overwhelmed. Can you suggest where to start?

Tackling everything at once is overwhelming. It is best to break the program down into categories, then prioritize. I recommend you divide the program into these nine categories: 

(1) Wound care team: Identify the team leader and members. Ensure the team meetings focus on prevention.

(2) Sufficient supplies: Ensure there are sufficient support surfaces (bed and wheelchair), heel-lift devices, incontinence management and topical treatment products, and nutritional supplements.

(3) Communication systems: When a wound is found, stress communication between shifts and between the hospital and nursing facility. When a wound declines, ensure proper notification.

(4) Pre-admission process: What is needed prior to admission?

(5) Admission process: Risk assessment and care plan development, head-to-toe skin assessment to capture admitted wounds.

(6) Prevention program: Risk assessment and care plan updates, turning and repositioning program, toileting program, placement of support surfaces for the bed and wheelchair, heel elevation if needed, and monitoring of weights and intake.

(7) Treatment program: Weekly monitoring of wounds, and access to wound care clinicians and vascular physicians.

(8) Monitoring program: Treatment sheet review for completion, turning and repositioning, implementation of interventions, care plans kept up to date, and wound dressing technique.

(9) Education upon orientation and yearly, on topics such as skin breakdown and care plan development.

Taking on a single category at a time makes the program more manageable.

Please send your wound treatment-related questions to “Ask the Expert” at [email protected]