The nursing staff at Pitt County Memorial Hospital is collaborating on the project. The effort began in 1996 at the request of critical-care nurses in the cardiac surgery units of the hospital. According to national studies, pressure ulcers occur in about 15 percent of intensive-care patients. Pokorny's first task was to analyze which patients were at risk of developing ulcers. Among cardiac surgery patients who developed ulcers, she found a range of ailments that compromised circulation.
Blood flow nourishes the skin and keeps it healthy.
They had circulatory problems, over 50 percent had diabetes, and a lot had lung problems. Because their surgeries required them to lie motionless for long periods, their risks increased. The next step involves testing whether stringent use of a well-defined regimen of care will prevent the development of ulcers. Nurses in the cardiac surgery unit perform a detailed assessment of a new patient's skin condition and recheck the skin twice a day, carefully documenting their findings each time. At any sign of a problem, they immediately begin outlined interventions, ranging from shifting the patients' weight to putting them on specialty beds.