Authors (including presenting author) :
Chan YYA(1), Ho PLE(2), Tong KSG(1), Kwok LPN3
Affiliation :
(1)Department of Medicine & Rehabilitation, (2)Quality & Safety Office, (3)Nursing Services Division, Tung Wah Eastern Hospital
Introduction :
Nurses who specialize in rehabilitation frequently assess and manage patients with pressure injury. Systematic measurement of pressure injury does help nurses to assess, monitor progress and guide the clinical decision making in the treatment of patient suffering from pressure injury. The PUSH (Pressure Ulcer Scale for Healing) is a research-validated tool developed by the NPUAP (National Pressure Ulcer Advisory Panel) that quickly and reliably captures the critical parameters to monitor the healing progress of pressure injury over time.
Objectives :
To implement the PUSH for inpatients with pressure injury in Tung Wah Eastern Hospital.
Methodology :
This program was piloted since Oct 2013. A Pressure Injury Assessment Form and reference guide were designed and endorsed in the Hospital Wound Management Team. The forms were revised in phase according to the audit result and staff feedback. Education forums were held to enhance staff’s understanding.
Result & Outcome :
The PUSH has been fully implemented in Tung Wah Eastern Hospital since Dec 2016. Evaluation on its use was conducted on 4 Apr 2018. All patients with pressure injury in rehabilitation wards were recruited. There were 11.3% patients (N=24 out of 212 patients) with total 57 pressure injuries. 6222 entries on the records in recent 14 days were audited. 99.2% and 91.2% documented the pressure injury location and stage key correctly. 92.19% calculated the PUSH score accurately and documented weekly. 82.38 % documented the types of dressing correctly. The overall compliance was 88.96%. Staff feedback on its use was collected by using a self-reporting questionnaire. The response rate was 92.2% (N=102). The overall satisfaction was 65.7%. Collected staff feedback and audit result was used as reference for design of the cluster assessment form.
PUSH was developed as a generic tool to provide consistent and evidence-based tracking system for pressure injury assessment particularly on the healing progress. Good compliance in the audit showing that the program was rolled out successfully. Pressure injury assessment requires critical thinking and judgement of nurses. The PUSH tool facilitates a consistent and effective communication among nurses in each shift of duty.
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