UNIT CHART/KARDEX AUDIT FOR PRESSURE ULCER PREVENTION

This report is required to be sent to: Sheila Moffatt, Room 4023, 4th Floor, HI

Or FAX 425-7033 on the 15th of each month.

Unit: ______Date audit performed: ______

Rm # / Adm
Braden
(yes/no) / Current
Braden
Score
# / Date of Current Braden completed / Care plan in ink if score is 18 or less (yes/no) / Sticker present on care plans with scores 14 or less (yes/no) / Pressure Ulcer Site / Pressure Ulcer stage

# of ulcers Stage I:_____ Stage II______Stage III______Stage IV______Unstageable______DTI______

A.  Total # Braden Scores completed in 7 days: ______

B.  Total # of Patients assessed: ______

C.  Percent of Braden s completed (A divide by B x 100):______

Prevalence: Total # of patients with ulcers:______divided by total # of patients=______

Incidence: Total # of patients with ulcers, which were caused in hospital (hosp acquired)_____

Monthly Report Sheet- Pressure Ulcer Prevention ROP

This report is to be sent to Sheila Moffatt via FAX by the end of each month.

Please FAX completed report to 425-7033.

Unit: ______Date: ______

Braden Score Risk Assessment performed (chart audit tool):

1) %Braden Scale completed with 24 hours of admission =

2) %Braden Scale updated at regular intervals (i.e. weekly, or with change in health status) =

3) % Most Recent Braden scores equal to or less than 18 =

4) % Braden Care Plans documented in black ink (for patients with Braden Scale scores equal to or less than 18 =

5) % Pressure Ulcer Stickers on patients Care Plan if Braden is 14 or less =

------------

Prevalence: Percentage of Pressure Ulcers on Unit (Audit of All Patients on Unit in 24 hour period)

A) Total # Inpatients with Pressure Ulcers on unit / B) Total # Inpatients
on Unit / C) Percent of Inpatients with pressure ulcers on unit ( A divided by B = C )

Incidence: Percentage of Pressure Ulcers on unit which occurred in hospital

A) Total # Inpatients with hosp acquired Pressure Ulcers on unit / B) Total # Inpatients
on Unit / C) Percent of Inpatients with hops acquired pressure ulcers on unit
( A divided by B = C )

Number and type of pressure ulcers on unit in 24 hour period

# Deep Tissue Injury / # Stage 1 / # Stage 2 / # Stage 3 / # Stage 4 / # Unstagable

·  Audits are to be completed within a 24 hour period on a monthly basis.

·  This report can be completed by one person or a group of people by assignment; day, evening or night shift, within the 24 hours.

·  This report is designed to be used to identify prevalence of pressure ulcers based on the number of patients with pressure ulcers on your unit and the specific stages being presented at the time of the audit.

·  The percentage of pressure ulcers is based on the total # of inpatients (B) in your unit/service area at the time of the audit.

Any questions contact:

Sheila Moffatt RN BN IIWCC

Pressure Ulcer Prevention Coordinator

473-2926 (office); 425-7033 (fax)

(created: Oct 2015)