Increase in pressure ulcers---HELP!!

[baygrl11]

I am experiencing an increase of facility acquired pressure ulcers at my LTC. (mostly stage 2's and a couple stage 3's)

I am the only wound nurse Monday-Friday. It is a 100-bed facility with full census at the moment. We have a lot of confused and immobile patients who I suspect are not being turned/changed as often as they should be. Does anyone have any ideas on what I can do to ensure they are receiving the proper care? I feel like nobody cares about pressure ulcers in my facility but me. I can't blame one person, its a team effort. Tomorrow I plan on signing briefs of the high-risk/confused patients at the beginning of my shift and noting which way the patient was turned when I see them, then rechecking throughout the day. I do not know what else I could do, if you have any suggestions on what I could do to 1) make sure patients are being turned/repositioned/briefs changed 2) How I can prevent future pressure ulcers, please let me know. I feel like I am one person and I cannot "police" a 100-bed facility to make sure briefs are being changed!

Thanks so much!

[Sam J.]

Signing briefs can backfire if the wrong person finds them, such as a surveyor or a family member- and it's not just not PC, it's gross, and a waste of time. You know full well if a diaper has been changed or not, without a time stamp. Don't you have a wound team? An IDT? An MDS Coordinator raising holy hell? I would think an increase in pressure ulcers, in this day and age, especially any stage 3!, would warrant a facility-wide call to arms. Also, they have to be reported- and that may cause a survey or even allegations of abuse. If your management isn't alarmed, something is amiss. Wound prevention, and wound care, requires the effort of a 'village'.