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August 2010, Volume 40 Number 8 , p 12 - 13


  • Jean S. Blankenship MSN, RN, CDE, PHCNS-BC
  • Abby S. Denby BSN, RN, CWON


HOSPITALS ARE challenged to provide increasingly complex care to higher acuity patients while keeping a close eye on the bottom line. As the demand for quality outcomes is increasing, so are financial pressures to avoid "no pay" events. In October 2008, the U.S. Centers for Medicare and Medicaid Services (CMS) began denying reimbursement for treatment of certain conditions considered avoidable, such as hospital-acquired stage III and stage IV pressure ulcers that "could reasonably have been prevented through the application of evidence-based guidelines."1Nurses, who are direct caregivers, are increasingly responsible for meeting these challenges, often without an increase in resources. They need effective communication, streamlined workflow processes, and optimal human resources to be successful.Martha Jefferson Hospital, a 176-bed not-for-profit Magnet®-designated community hospital, has improved quality outcomes by using unlicensed assistive personnel (UAP) to champion pressure ulcer prevention (PUP) strategies. This article describes this initiative and technology improvements that support these strategies.Recognizing the contribution that UAP make to patient care, our department of nursing education began sponsoring a program called Uniquely Yours in January 2006. The purpose was to recognize UAP for their hard work and optimize their promotion of patient safety and quality. Held once each month, Uniquely Yours luncheons provide an opportunity for UAP from across the organization to gather, learn, and discuss issues of concern.At the first Uniquely Yours luncheon, the nurse educator discussed PUP and the important role UAP play in noticing subtle changes in skin condition, and gave all UAP a pocket guide with tips for preventing pressure ulcers. She also led a discussion about potential barriers to implementing skin care strategies and followed up with each nursing unit to ensure that proper equipment and resources were available to implement PUP strategies.Several

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