SSKIN care bundle
As part of
an American healthcare initiative, representatives from the
Institute for Healthcare Improvement and Ascension Health
together developed a blueprint for change in pressure
Part of this blueprint involved defining best
practices, to which the original SKIN (Surface, Keep moving,
Incontinence, Nutrition) care bundle was developed. After learning
about the care bundle approach used by colleagues in
Wales to prevent pressure ulcers, the care bundle was then tested
in a small variety of care settings in Scotland.
The results of this work, together with
discussions with clinical and quality improvement colleagues,
highlighted that the element of skin inspection (accounting for the
second ‘S’ – SSKIN) should be brought to the fore. By checking the
skin more regularly when delivering best practices, early signs of
pressure damage will be identified sooner by staff.
The SSKIN Care Bundle is a powerful tool as it
defines and ties best practices together. The bundle also makes the
actual process of preventing pressure ulcers visible to all. This
minimises variation in care practices. A process is a
series of actions which are required in order to achieve a desired
outcome (such as a reduction in the number of pressure ulcers).
Reliably delivering all elements of the care bundle at every
care opportunity, will improve the pressure area care that a
person receives. This will have impact on improving care
In order to know if a people are complying
with a process, it is useful to measure if they are.
Building on the improvement work of Annette
Bartley (who is an independent Consultant and Director of UK Safer
Patient Network), a simple tool to measure process compliance has
been developed, tested and adapted (see Compliance measurement
chart). It is useful to collect process compliance data in
real time (i.e. on the day you check the care bundle charts) as
this enables continuous improvements to be made at the time,
based on the data you collect.
Published Date: 15 April 2011