Investigating multidisciplinary team management of pressure injuries in sub-acute care

Ms Alice Doring1, Ms Juliette Mahero1

1Qld Health (TPCH), Brisbane, Australia

The prevalence of pressure injuries (PI), both hospital acquired and present on admission, is a worrying concern. The 2016-2017 financial year attracted $510,000 in PI penalties at The Prince Charles Hospital alone. Evidence-based policies for the prevention and management of pressure injuries describe the benefits of a multidisciplinary team(MDT) approach1.

This project aimed to investigate MDT management of PI in the Rehabilitation and Acute Stroke (RAS) Unit at a tertiary hospital in Brisbane, QLD. A four-week prospective audit was conducted on patients who were admitted to the RAS unit with a PI(N=9) or obtained a hospital acquired pressure injury during their admission(N=0). Documentation including that at point of handover of care, discharge planning processes and communication of pressure injuries at weekly MDT meetings were audited. Clinical staff were engaged via surveys(N=13) to assess current practice and perceptions of responsibility for care.

Results showed that 12.5% of the time, PI were documented on handover to the sub-acute ward via medical admission summary. 62% of clinicians did not routinely note a PI in departmental handover processes. 66% of patients had their pressure injury documented on summary pages as per local hospital protocol. PI progress discussions at weekly MDT meetings were conducted in 3.7% of the cases (N = 9). 22% of patients were discharged with no documentation of PI healing status on medical discharge summary.

Results were presented with the MDT and a unit pressure injury week was held to improve awareness and increase education around PI care. Changes were made to local handover and case conference templates. In future, audits will be conducted annually to reassess management and address key areas for improvement.

While structured management plans for MDT PI care exist, lack of awareness, documentation and communication amongst the MDT and on transfer of care is compromising patients PI care.

References:

1)            Australian Wound Management Association. Pan Pacific Clinical Practice Guideline for the Prevention and Management of Pressure Injury. Abridged Version, AWMA; March 2012. Published by Cambridge Publishing, Osborne Park, WA.


Biography: To be confirmed

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