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Please note! It is not required to include documentation for each example given

Program Element #1

Possible Examples

Senior management is engaged and committed to the program

  • Program leader has designated accountability and allocated time for program implementation and maintenance.

  • Have invested in staff/FTEs to support prevention efforts

  • Have invested in equipment that supports prevention of skin damage

  • Requires program leader have wound care certification and requires/supports education and certification for team members

  • Requires relevant root cause analysis (RCA) for specified nosocomial skin injuries.

  • Requires and provides time for front line staff members and relevant disciplines to participate in RCA process

  • Requires ongoing communication that share actual patient experiences

  • Requires ongoing communication of facility-wide goals, measurements and outcomes

  1. Description of senior management role and involvement

  2. Description of new technology and its impact

  3. Description of staff allocation for program

  4. Description of RCA process including front line staff participation

  5. Facility publications (print or electronic)

  6. Change Management Plan

  7. Other (include your own examples)

 

Please note! It is not required to include documentation for each example given

Program Element #2

Possible Examples

Clinical champion shows strong qualifications and demonstrates leadership of program

  • Education and clinical background demonstrate expertise in the prevention and management of skin and wound conditions

  1. CV/resume

  2. Awards or recognitions relevant to this program (not a requirement for award consideration) e.g. institutional/system awards, Chapter or Regional WOC recognition for program, community awards

  3. Other (include your own examples)

Please note! It is not required to include documentation for each example given

Program Element #3

Possible Examples

Program has a designated, engaged, interdisciplinary skin team that includes representation from multiple, relevant disciplines, departments, and care settings

  1. Description of team members and their role

  2. Team charter, meeting frequency and format etc.

  3. Other (include your own examples)

Please note! It is not required to include documentation for each example given

Program Element #4

Possible Examples

Front line staff is empowered and accountable for decision making.

  • Unit based skin teams

  • Management requires (and provides time) for front line staff members to participate in relevant root cause analysis (RCA).

  • Staff is evaluated based on commitment to and achievement of skin safety goals

  • Policy and culture provides for effective communication of skin injury risk and preventive interventions between caregivers, disciplines, departments, and care settings

  1. Description of unit based skin teams

  2. Example of commitment statement(s) and description of where they are posted on units or patients’ rooms

  3. Description of live compliance audits (e.g. positioning audits similar to hand washing audits).

  4. Dashboards sharing nosocomial rates that are posted on units

  5. Description of celebrations, treats, or awards

  6. Description of performance review criteria that address skin safety.

  7. Description of handoff method

  8. Description of Control Plan to ensure ongoing measurement and long term sustainability of program

  9. Other (include your own examples)

Please note! It is not required to include documentation for each example given

Program Element #5

Possible Examples

Program has specific, understandable, accessible written prevention protocols

  1. Policies and procedures-e.g. risk assessment, procedure for skin inspection

  2. Examples of protocol(s) (Note-manufacturer’s copyrighted programs are not eligible for submission)

  3. Other (include your own examples)

Please note! It is not required to include documentation for each example given

Program Element #6

Possible Examples

Program has specific targets and outcome metrics

  1. Measurable goals are clearly articulated

  2. Staff audits showing compliance with designated program components,

  3. P&I/ Skin Damage Survey Process and Goals

  4. Description of process for ongoing data collection of incidents/events and methods for insuring accuracy

  5. Other (include your own examples)

Please note! It is not required to include documentation for each example given

Program Element #7

Possible Examples

Product formulary is comprehensive, staff accessible, and user- friendly with a process for ongoing review.

  1. Examples of decision-making tools to facilitate appropriate product use.

  2. Description of process for annual review of tools and formulary.

  3. Example of user friendly ordering process that facilities fast delivery of products to patients

  4. Note! Formulary must be described generically by product category

  5. Note! If your formulary list includes both skin and wound care products, you can submit it as is. There is no need to create a separate list of skin care products for this submission

  6. Other (include your own examples)

Please note! It is not required to include documentation for each example given

Program Element #8

Possible Examples

Program delivers creative and effective staff education

  1. Examples of content /methods for new employee orientation

  2. Examples of content/methods for ongoing (i.e. annual) education, (competencies etc)

  3. Examples of content/methods for educating other disciplines (Respiratory Therapy, IV team, OR, Radiology, Transport, Lab)

  4. Results of post-tests or alternative evaluation method

  5. Examples of educational tools that demonstrate excellence in content and creativity

  6. Other (include your own examples)

Please note! It is not required to include documentation for each example given

Program Element #9

Possible Examples

Program delivers creative and effective patient education

  1. Examples of educational tools (i.e. videos, brochures) that demonstrate excellence in content and creativity

  2. Other (include your own examples)

Please note! It is not required to include documentation for each example given

Program Element #10

Possible Examples

Program shows sustained results for at least one year post implementation

  1. Data (e.g. graphs, charts, etc.) illustrates a decrease in nosocomial skin injury and maintenance of improvements

  2. Results of P&I/ Skin Damage surveys (i.e. incidence studies/surveys for pressure ulcers, IAD, skin tears, etc)

  3. Other (include your own examples)