Hospital recognized for abstract results

Two abstracts — short summaries of researched studies — submitted by Sierra View District Hospital to CALNOC, Collaborative Alliance for Nursing Outcomes, were chosen to be displayed during the organization’s 2011 conference held in June.

The abstracts were two of 21 accepted abstracts, and the only two from the surrounding Porterville area, reported registered nurse Sue Altamirano to the hospital’s board of directors during the June 28 regularly scheduled Board meeting at Sierra View District Hospital.

The submissions dealt with pressure ulcer prevention (PUP) and a study on restraint data that led to organizational changes in a hospital bed’s side rail management.

PUP was designed to start in the emergency department and follow a patient through to discharge, Altamirano said.

All licensed nursing staff, with the exception of those in Women’s services, participated in a pre-test prior to taking a mandatory class designed for their level of expertise regarding pressure ulcer prevention. The 275 registered and licensed nurses attended a four-hour presentation and 86 certified nurse assistants attended a two-hour presentation. Afterwards all participants took a post test.

And, the statistics prove there was remarked improvement in the results, especially since potential problems could be identified upon emergency-room arrival, prompting the nurses into immediate intervening action to prevent the pressure ulcers.

“What we found is that the level of awareness in our nurses increased in things we needed to do,” Altamirano said. “The [licensed staff] post test scoring average increased to 93-percent representing an increased knowledge and awareness of wound and skin issues, documentation and prevention. The [CNA] post test average score increased to 89-percent, showing an increased awareness of care and documentation.”

Through quarterly trend reporting, Altamirano said she was able to show an increased awareness of patients at risk for pressure ulcer development on admission that corresponded with the pressure ulcer prevention training.

“Preventative interventions is the real emphasis with the staff,” Lisa Lieurance, RNC and clinical manager of the medical surgical department. “Guidelines have been developed, following the latest evidence-based practices, for assessing, documenting, treating and implementing preventative measures.”

But Sierra View District Hospital has many dedicated nurses who are proactive and turn their patients every two hours — a guideline and recommendation for best practice, said Lydia Rodriguez, RN and clinical manager of the intensive care unit.

““The PUP program at SVDH has been a very successful program because immediately upon admission a patient is assessed by a nurse for any potential wound or skin issues. The PUP program allows nurses from different floors to collaborate and follow a regimen that identifies patients at high risk and initiate treatment to prevent or halt further deterioration of skin breakdown,” Rodriguez said. “As an example, the Braden scale is a tool used by every nurse daily to assess patients at risk for skin breakdown and physician standing orders are initiated immediately upon any findings. Recently, SVDH purchased many specialty beds with stage IV mattresses, which is an air loss mattress. The product line used to treat wounds is from Medline and is part of the treatment regimen.”

With the restraint data abstract, RN Patricia Becker said she noticed that the Risk Management Department had developed a Falls/Risk Screening and Scoring Tool but that it had not been updated in five years. She also noted that the Critical Care Unit had recently replaced all beds in the ICU with therapeutic beds which require all four side rails to be up and locked to activate the continuous rotation cycle.

With that in place, a team of professionals, including bedside nurses and representatives from Risk Management, met to review evidence-based practice literature related to the use of four side rails — and the literature revealed that patient safety was improved when an organization adopted a three-side rail practice to prevent falls.

Because of this, the hospital improved patient safety and decreased the use of four side rails, resulting in a ‘No recommendation for Improvement’ in restraint standards during their 2010 survey by the Joint Commission.

Contact Esther Avila at 784-5000, Ext. 1045, or eavila@portervillerecorder.com.