Abstract
Intro
Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic method of recognising physical, psychosocial, and functional abilities & limitations of an elderly person. Assessment of the skin is an essential element of the physical domain of CGA as aging skin is more susceptible to loss of skin integrity. Common conditions including pressure sores, purpura from long term anticoagulation and steroid use, and venous stasis eczema put patients at high risk for developing infections. Therefore, it is essential to be cognizant of the condition of the elderly patients’ skin. We aimed to improve frequency of skin assessments performed by doctors working on the two geriatric wards of Southend University Hospital, over 6 weeks. Our baseline data illustrated that 15.8% skin assessments were documented by doctors on both wards and 80.7% by the nurses.
Method
Three bi-weekly interventions were carried out. PDSA 1 introduced a concept of regular skin assessments, highlighting its importance in elderly population, through informal teaching at morning meeting. PDSA 2 delivered formal teaching led by tissue viability nurse and finally, PDSA 3 presented a poster to act as reminder for regular skin assessments as well as provision of contact details to escalate positive findings.
Results
PDSA 1 showed improvement from 15.8% to 31.6% in frequency of performing skin assessments. PDSA 2 showed a decrease in number of skin assessments at 11.9%, which was less than baseline. PDSA 3 also showed a decrease at less than baseline and only resulted in 8.8% assessments completed.
Conclusion
The findings showed the first intervention as most impactful indicating benefit of teaching session focused on skin assessments in elderly patients. It is suggested that a regular teaching session is carried out in every rotation with regular audits for a more sustainable outcome.