Managing Skin and Wound Care On a BMT Unit

Significance & Background:

As products and treatments change for wounds and pressure ulcers, BMT nurses are faced with the lack of knowledge and comfort to care for these types of changes. With the development of unit experts through a hospital supported program our unit recognized an increased problem with incontinence associated dermatitis commonly caused by unmanaged diarrhea from treatment.  Diarrhea leads to an increase in skin breakdown and wounds; putting patients at risk for infection and pain. Our unit also noted that nurses lacked the general knowledge of how to prevent, stage and treat pressure ulcers as well as incontinence associated dermatitis.

Purpose:

The purpose of the project was to increase the BMT nurses knowledge and comfort of skin and wound care issues commonly found on a BMT unit. A special emphasis was placed on pressure ulcers and incontinence associated dermatitis.

Interventions:

Ongoing education of unit experts was supported and encouraged by a hospital supported program. A quarterly newsletter was distributed to staff with reminders and updates on pressure ulcers and IAD. Staff was mandated to read the updates. A skin cupboard with supplies and a skin binder was developed to be used as a resource for nurses. A checklist was developed to help the nurses comply with hospital policy for pressure ulcer assessment, documentation, and management.   A twenty minute power point presentation focusing on pressure ulcers and IAD was developed and provided to staff at staff meetings and in-services throughout the year.

Evaluation:

A survey was sent to the nurses to determine their knowledge level and comfort on wounds and incontinence associated dermatitis before and after the interventions.

Discussion:

Ongoing development and reinforcement is needed for BMT nurses to gain comfort and increase their knowledge with pressure ulcers and IAD.  Recruiting and retaining wound experts is an ongoing issue.