Patient skin is assessed daily and evaluated using a risk assessment tool to identify patients who are at risk for pressure injury development. Pressure injury prevention includes identification of skin breakdown, ensuring appropriate offloading, utilization of offloading devices, prevention dressings, and application of skin barriers. Populations who are at higher risk for pressure injury development include: acutely ill and/or in critical care, sustained a hip fracture, spinal cord injuries, diabetes mellitus, elderly, and have experienced trauma and/or prolonged surgery. Nurses compare pressure injury results to other hospitals of like size and Magnet^® hospitals to identify opportunities for improvement across the organization.

HRH has robust and accurate processes for the assessment, prevention, and treatment of pressure injuries which is tailored to each patient we serve. An interprofessional Skin Committee exists and meets monthly to examine and improve processes across the organization. When entering the organization for an emergency, surgery, and/or a hospital admission, nurses use the four-eyes skin assessment approach. This approach is where two nurses come together to assess the entire patient at the same time to evaluate for any existing pressure injuries. This assessment technique continues throughout a patient’s stay. Any identified pressure injuries are tracked and treated to heal as soon as possible.

Many steps are taken to avoid pressure injury development while in the hospital, including turning patients from side-to-side a minimum of every two hours, using special products/devices/beds, providing the highest levels of nutrition, and access to trained experts in skin care.

In the uncommon situation a pressure injury would develop in the hospital, specific pressure injury treatments occur quickly to get that area on a track to healing. In collaboration with the HRH Wound Healing Center, a wound care certified clinical nurse specialist rounds on all hospitalized patients with a pressure injury to assure optimal treatments are in place.