3M and the Wound, Ostomy and Continence Nurses Society (WOCN) have named the Dermal Defense Team at Temple University Hospital the eighth annual 3M Award for Excellence in Skin Safety award winner. Members of the Dermal Defense Team – which includes over 58 skin champions – accepted the award at the WOCN Society’s annual education event, WOCNext, in Nashville.
A 732-bed Magnet-designated Philadelphia hospital, 3M described Temple University Hospital as one of the region's most respected academic medical centers as well as the chief clinical training site for the Lewis Katz School of Medicine at Temple University. As a Level 1 trauma center, the Dermal Defense Team has changed the conversation from one where skin was one of the later priorities in patient care to staff thinking about skin as soon as someone is admitted.
“Diligence and commitment are required to implement pressure ulcer prevention protocols,” Anna Kuang, Associate Medical Director, 3M Health Care told Healthcare Purchasing News. “Successful outcomes are achieved by addressing the underlying etiologies of pressure injury. The three goals of the Dermal Defense Team execute along these lines with the following principles: alleviation of existing pressure through repositioning, reduction of physically raised surfaces from excessive layers under the patient, and utilization of effective barriers and dressings that simultaneously protect the skin and reduce pressure.”
Formally organized in 2014, the Dermal Defense Team expanded in 2016 when the hospital began the process of seeking Magnet status. The team now includes over 58 skin champions – including patient care assistants (PCAs), registered nurses (RNs), representatives from all nursing units, and departments such as physical therapy – who meet monthly to discuss goals, results, and education on preventing pressure injuries and skin breakdown.
Bright yellow team T-shirts, proclaiming members’ duty “To Prevent, Protect and Save,” are worn during monthly data collection rounds and serve as a cornerstone of the team. The mantra was developed by the comprehensive team as a rallying cry and serves as a visual commitment to patient care. “Our T-shirts are highly visible,” said Diane Wagner, MSN, BSN, RN, CWOCN, Clinical Nurse Specialist and Dermal Defense Team Program Chair at Temple University Hospital. “And, not only does visibility help reinforce support for skin care across all areas of the hospital, it also facilitates conversations with patients and families about caring for skin and helps those families feel comforted through our care.”
In early 2018, the team refocused on prevention protocols through comprehensive education, risk assessment, and other preventative efforts. At that time, the members set a goal of zero Stage 3 and 4 pressure injuries developed. That goal was quickly met in Quarter 3 of 2018, and the team has several additional metrics in place that it is working toward that are focused on improving skin outcomes:
- 100 percent compliance with using sacral and heel foam borders when appropriate
- Using fewer than four linen layers on beds
- Having more patients out of bed or positioned on their side rather than on their back
“These are all measures that are easily implemented that do not require additional equipment,” Diane Wagner, MSN, BSN, RN, CWOCN, Clinical Nurse Specialist and Dermal Defense Team Program Chair, Temple University Hospital told HPN. “The linen and foam borders are evidence-based preventative measures that can be carried out by all nursing staff with minimal in-services or education. Less layers of linen promote better functioning of low air loss beds which, in turn, reduces the risk of developing pressure injuries. The development of sacral pressure injuries in hospitalized patients is a common issue that hospitals must deal with. Turning patients side to side and getting them up into a chair minimizes the risk of developing them.”
