Christiana Care Health System received Certificates of Excellence from the Centers for Medicare & Medicaid Services (CMS) for collaborating in projects to prevent hospital-acquired infections and pressure ulcers.
The CMS patient-safety projects were conducted by Quality Insights of Delaware (QID). As part of a larger group encompassing West Virginia, Pennsylvania and Delaware, QID gathered data and measured results in collaborative efforts by health care providers to reduce transmission of hospital-acquired methicillin-resistant staphylococcus aureus (MRSA) and to reduce the occurrence of pressure ulcers.
The statewide collaborative project to reduce MRSA took place from August 2008 to July 2011. At Christiana Care, the project focused on MRSA prevention strategies that were implemented in the intensive-care unit at Wilmington Hospital (WICU), including hand-hygiene education and monitoring, educational sessions with staff and new isolation signs. Educational seminars and sharing sessions allowed hospitals to share successful strategies and barriers statewide.
“At Christiana Care, WICU reported no MRSA transmissions during several months of the project,” said Kathleen Wroten, RN, Infection Prevention manager.
The project to reduce pressure ulcers, which included nursing homes and other stakeholders, was conducted from August 2008 to January 2010. Pressure ulcers—also known as bedsores—occur when pressure against the skin reduces blood supply and the affected tissue dies. Pressure ulcers can occur when someone remains in one position too long. They are a risk for patients confined to a hospital bed or wheelchair.
Christiana Care completed a hospital baseline self-assessment survey for pressure-ulcers reduction. Initial project strategies consisted of:
- Organizational commitment, reflected by the interdisciplinary teams, policies and protocols, accountability and staff education.
- Daily risk assessment of patients.
- Pressure-ulcer prevention through daily skin inspection, moisture management, optimal nutrition and hydration, and minimizing pressure.
- Treatment and documentation.
Participating hospitals administered patient-safety surveys at baseline and re-measurement. These survey instruments included the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture and the Hospital Leadership and Quality Assessment Tool.
Wound-ostomy continence nurse Beth Donovan, MSN, RN, CWOCN, said that QID’s data collection tool helped Christiana Care define an opportunity for improvement in moisture management. Moisture is a significant cause of pressure ulcers in patients whose condition includes incontinence. The pressure-ulcer prevention project team focused on improving moisture management on one unit at Wilmington Hospital, and their findings ultimately helped to improve pressure-ulcer prevention throughout Christiana Care Health System.