Maintaining Patient Skin Integrity Requires Identification of Knowledge, Practice and Product Gaps

The University of Chicago Medicine team with the 3M Award for Excellence in Skin Safety. From left to right: Jenny Sala, Kathleen Hudson, Susan Solmos, Foluke Omosule, Marianne Banas.

Skin integrity is a building block of infection prevention, with pressure injuries and wound-related complications posing as a major threat to good patient outcomes.

In May, 3M and the Wound, Ostomy and Continence Nurses Society (WOCN®) announced that the University of Chicago Medicine’s successful “Countdown to Zero” skin integrity program had received the sixth annual 3M Award for Excellence in Skin Safety. The program was honored for reducing the number of preventable skin injuries – including an 83 percent reduction in pressure injuries – within the academic medical center.

Susan Solmos, MSN, RN, CWCN, manager of nursing clinical services at University of Chicago Medicine, explains that the majority of acute-care institutions are aware of their hospital-acquired pressure injury rate as a part of their overall patient skin integrity monitoring. “Most hospitals track hospital acquired pressure injury (HAPI) rates particularly since reimbursement penalties were implemented by the CMS in 2008.”

The Countdown to Zero program began in 2014 after an analysis of nursing practices and available products was conducted to understand factors contributing to the system’s higher- than-average hospital-acquired pressure injury rate. A monthly auditing program was established to help lower the point prevalence of pressure injuries, incontinence-associated dermatitis (IAD), intertriginous dermatitis (ITD) and friction injuries.

Pre-program analysis uncovered that some clinicians were unable to distinguish between certain types of skin injuries, which could lead to improper treatment. Therefore, clinician education became a cornerstone of the Countdown to Zero program.

“Nursing practice, including staging and differentiation of pressure injuries…

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