Action Taken for Improvement Critical-care nurses constructed a standardized plan to deliver interventional hygiene (IH). An IH clinical excellence team was formed for the appropriate use of specialty beds, patient hygiene, and pressure ulcer prevention, which took place in the critical-care unit at Elkhart General Hospital. The team included nurse volunteers from each CCC shift. An informal meeting discussing the concept of IH was held outside the institution. The meeting was a brainstorming session that included the nurse manager and nurse educators. The clinical excellence team decided to form 3 smaller work groups called “beds”, “baths”, and “bottoms” groups with 4 to 5 members each. The BBB group had separate meetings to discuss goals, plans, education and steps for implementation. Infectious control, wound, ostomy, and skin care nurses were consulted for further research Eigsti, J. E. (2011).
The Bed Group The bed group focused on optimizing the function of the beds presently used. The issues concerning present bed use was verbalized by the bed group, including routine maintenance and malfunctioning beds. Investigations of nonbed products, assisting patients with tuning and positioning were done. Other actions taken included training the staff on maximal operations of CCC beds, limiting the different types of specialty beds available for rental in CCC, and clarifying indications for the use of specialty beds Eigsti, J. E. (2011).
The Bath Group The bath group focused on 2 areas of concern, including nonexistence of a standardized use of bathing products or a bathing process and potential surface contamination and transmission of infectious agents during bathing in the CCC. Actions taken included several types of bathing agents were supplied by the hospital and additional products were brought in from home by patients, families and nurses. Bathing products were researched, discussions of possible surface contamination and transmission of infectious agents during bathing in the CCC were held. Cultures of tap water, washbasins, and used bars of soap were taken, which identified bacteria. MRSA cultures were administered on patients being administered and discharged, which led to patients with MRSA being isolated. Daily bathing, along with moisturizing the skin was recommended, which allowed thorough skin assessments and early detection of breaks in skin integrity. The use of disposable all-in-one bathing cloths was used, eliminating rough washcloths that were associated with dermatitis and cross-contamination when basins are removed Eigsti, J. E. (2011).
The Bottom Group The bottom group identified many products available at the hospital for the prevention and treatment of pressure ulceration and incontinence associated dermatitis (IAD). The bottom group explored prevention methods for IAD and its’ related pressure ulceration. Actions taken included limiting product types, standardize product use, and provide nursing education. 1-step product that cleaned, moisturized, protected the skin, and did not require rinsing was used. In addition Disposable Shield Barrier cloths containing 3% dimethicone were