Under Pressure – An evidence-based Community Occupational Therapy pressure injury quality project.
Taryn Doyle1, Jane Bancroft1Illawarra Shoalhaven Local Health District, Port Kembla, NSW, Australia
Abstract
Pressure injury (PI) prevention and management is a key priority within NSW Health due to their significant financial cost but more importantly the cost to consumer’s quality of life and health outcomes. Translation of evidence-based practice (EBP) into clinical practice is essential in preventing and management PIs. Release of the 2019 international best practice Prevention and Treatment of Pressure Ulcers/Injuries Guidelines, and subsequent updating of the NSW Health and Illawarra Shoalhaven Local Health District (ISLHD) Pressure Injury Management policies, highlighted a gap in clinical application of evidenced based PI management in the Domiciliary Occupational Therapy Teams at Port Kembla and Shoalhaven hospitals. Data was gathered through file audits and staff surveys to determine areas for improvement. Key findings were a lack of clarity for multidisciplinary (MDT) team referrals, knowledge and confidence with skin, nutrition and pain screening and lack of specificity with PI interventions. An MDT across ISLHD came together to address the findings and develop the following aim statement. By May 2023, 95% of clients at risk of pressure injury within ISLHD Domiciliary Occupational Therapy will receive evidence-based practice as measured by: Pain management assessment; Nutritional screening; Skin assessment/Pressure injury screening; Individualised mobility plans. Outcomes achieved included an ISLHD EBP pressure injury audit; Waterlow skin assessment eMR cheat sheet; MDT referral pathways and criteria; Implementation of a pain scale; PI Mandatory training; PI Education Resources (heel, sacrum & ischial tuberosities); PI management templates. These improvements are process embedded for sustainability and spread to enhance PI practices across NSW Health.
Biography
Taryn Doyle is an Occupational Therapist from NSW Health’s Illawarra Shoalhaven Local Health District (ISLHD) and current Occupational Therapy Unit Head. She has recently graduated from the first round of the NSW Health Patient Safety and Quality Program where she and her co-lead, Jane Bancroft, completed a Quality Project on embedding evidence-based practice use in community-based Occupational Therapy care. Taryn has a passion for pressure injury prevention and management and is moving to expand the project and improvements across the multidisciplinary team in ISLHD through education and system processes.