California CNS Reverses High Rate of Pressure Ulcers
Despite recent improvements in the treatment of pressure ulcers, the nation's most common and dangerous bedsore continues to dramatically extend hospital stays, complicate recovery and increase the risk of infection. Hospital-acquired pressure ulcers kill nearly 60,000 people each year. The success of one California nurse could serve as an impressive model for other institutions to follow in the reduction of pressure ulcers.
Margaret Talley, RN, CNS, CWCN-AP, a wound care clinical nurse specialist for Palomar Pomerado Health in Escondido, Calif., took an existing wound care program to the next level, dramatically reducing the percentage of patients with hospital-acquired pressure ulcers. For her efforts, Talley has received the prestigious Cherokee Inspired Comfort Award. She is one of 10 honorees nationwide in 2007.
In 2003, Talley discovered that two acute care hospitals within Palomar Pomerado Health had been showing a much higher rate of pressure ulcer prevalence than the national benchmark. Talley began a one-on-one mentoring process with the RN skin team members. Within about a year, each member of the team was able to perform pressure ulcer prevalence assessments and data collection independently. In addition, they serve as consultants to their peer nursing colleagues regarding skin care.
"We have an evolving evidence base for effective nursing care that provides us with direction and challenges for implementation at the patient level. We evolve as both students and teachers wherever our nursing careers take us."
With Talley at the helm, the team's outreach activities included: conducting a large-scale education program; working to accurately identify and document community-acquired pressure ulcers; modifying the computerized charting system to fully capture pressure ulcers during admissions assessments; and training bedside staff to be able to accurately assess skin and stage lesions. They also co-developed standardized order sets for pressure ulcer care and system standardization of the wound care product formulary with the organization's Wound Care Center.
In 2006, the percentage of medical patients with hospital-acquired pressure ulcers dropped from 10 percent to three percent, with a net effect of fewer complications for patients and shorter hospital stays.
Today, skin care has become a major strategic initiative for Palomar Pomerado Health's nursing division. The skin team has representation for each nursing unit across the district. Talley continues to orient new staff. She mentors nursing students on-site, presents in classroom settings and serves as a preceptor for graduate nursing CNS students. She works closely with geriatric and palliative care clinical nurse specialists for an integrative, comprehensive approach for this patient population. Additionally, she has worked closely with the district CNS team to increase their knowledge regarding skin care practices and innovations.
Talley has shared the program innovations regionally, statewide and on a national level. Most recently, her skin team program was published in the American Nurses Association publication, Transforming Nursing Data into Quality Care. She has also presented at the national conference of the Wound, Ostomy and Continence Nurses (WOCN) Society.
"No matter how much I learn about the practice of nursing and my specialty, I realize there are always more practice questions that need to be answered," says Talley."I have been a student of nursing since 1975, continually returning to school to indulge my passion for learning and now I am embarking on earning my Ph.D."
As a Grand Prize Winner in the award's APN category, Talley receives an all-expense-paid Caribbean cruise for two, a crystal award and a wardrobe of Cherokee healthcare apparel. She also will appear in the nationally distributed Cherokee Inspired Comfort Award 2008 calendar.
The award is granted annually by Cherokee Uniforms to recognize nurses and other non-physician healthcare professionals who demonstrate exceptional service, sacrifice and innovation and have a positive impact on others' lives. This is the 5th year the leading designer and manufacturer of healthcare apparel has honored inspirational caregivers.
Since the Cherokee Inspired Comfort Award was established in 2003, more than 5,300 healthcare professionals have been nominated in the Registered Nurse, Advanced Practice Nurse, Licensed Practical Nurse/Licensed Vocational Nurse, Student Nurse and Non-Physician Healthcare Professional categories. A panel of nursing professionals and Cherokee representatives evaluates nominations and grants the awards.
For every nomination received in 2007, Cherokee Uniforms donated $1 to national health-centered charities. The total amount was divided equally among the American Cancer Society, American Heart Association and the Alzheimer's Association. Since 2005, Cherokee has donated over $3,300. Proceeds from Cherokee Uniforms products support healthcare professionals through initiatives such as the Cherokee Inspired Comfort Award, an annual calendar and the A Nurse I Am Film and Scholarship Program. Cherokee Uniforms will be accepting nominations for the 2008 Cherokee Inspired Comfort Award beginning March 1, 2008 through May 31, 2008.