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KALAMAZOO, Mich.—An innovative effort is underway to better detect and prevent pressure wounds at Ascension Borgess Hospital, and °ÄÃÅÁùºÏ²Ê¹ÙÍøÖ±²¥ nursing students are leading the charge.

"This is cutting-edge work," says Dave Neuman, wound ostomy coordinator at Ascension Borgess.  

Students Maddie Bies, David Le and Jordyn Swenson are conducting research and compiling data to help the hospital determine if a new pressure ulcer risk assessment scale could lead to better patient care. Neuman emphasized the potential impact of the Western team's work in an email to their professor, Dr. Kelley Pattison.

Currently, the Braden Scale is the industry standard in terms of scoring risk factors for ulcers. But scoring is subjective and can vary depending on who is filling out the chart. The Shieh Score is a new tool developed to be more objective.

"What the °ÄÃÅÁùºÏ²Ê¹ÙÍøÖ±²¥ students are doing is retrospectively analyzing our internal data utilizing the Shieh scale to see if we could have captured more patients who would have been pressure injury risks who were not labeled as risks," Neuman says.

The students are working with Neuman and his colleague Tammy Austin, a wound nurse and preceptor, through a nursing leadership and management class that all Bronson School of Nursing students take in their final semester before graduation. It pairs students with a nurse leader in the community to do a project related to patient safety and quality.

"The fact that we're last-year nursing students on the forefront of this effort is pretty phenomenal," says Le, of Portage. "I really love research, and this project reflects how much care has evolved—and we're adding to it. I know we're just at the beginning, but it's crazy to think that one day maybe hospitals will be using this Shieh scale."

"Health care is ever-changing; nursing is ever-changing. We're always researching and updating our practices," adds Swenson, of Homer Glen, Illinois. "I like seeing this new scale and seeing how well it's working so far. … I'm really excited to see where this goes and see how it's implemented into this hospital and possibly throughout the country."

The results of the research are being presented to hospital leadership and could potentially lead to the Shieh Score being adopted not just locally but systemwide within Ascension.

"The initial data from the students' research is already so compelling that nursing leadership is excited about the possibilities," says Neuman.

It's also opening up potential future career possibilities for the students, who admit they'd never considered research or community nursing before this project.

"It's really cool because we're getting to step into not just the clinical side of nursing that we've been so used to, we're able to dig into the research and continuing education aspect," says Bies, of Kingsley, Michigan, who plans to start her career as a patient care nurse. "This has opened the doors and shown that this is a part of nursing and this is an option for me."

UNIQUE EXPERIENCE

Bies, Le and Swenson also recently led the annual International Pressure Ulcer/Injury Prevention (IPUP) Survey at Ascension Borgess, which is conducted by more than 1,000 facilities around the globe to assess the number and severity of pressure wounds in health care systems. The Western team coordinated a group of two dozen fellow nursing students to staff the daylong effort.

"To the best of my knowledge, this is the only student-run operation in the nation. We've been doing this in collaboration with Western for about five or six years now, and it's been fantastically successful," says Neuman.

Six years ago, a Western nursing student in the same course created the student-led survey as her project, and it has grown every year. This year's student volunteer group was the largest the hospital has seen.

"I've had nothing but excellent students from Western in my entire tenure here," Neuman says. "It says a lot about our student externs and the buy-in from the University. It's just a great partnership."

"Every year it gets better," Austin adds. "This group is the best we've had yet. They're absolutely phenomenal."

It also allows students to gain resume-worthy experience that could give them a leg up when they begin applying for jobs.

"We're really honing in on advancing their assessment skills. When they do these surveys, they're finding that the pressure ulcers are not always properly charted, so it's giving them a lot of practice for assessment skills and communication skills in explaining what they are doing to patients," says Jaime Neary, faculty specialist II of nursing. "We tell them all the time how important charting and documentation is … but this really gives them examples and will help their skills after graduation."

The opportunity to focus on patient care and have a measurable impact at the hospital reinforces the reason the students chose Western to explore this profession in the first place.

"I want something where every day I walk away knowing that I made a difference in someone's life," Bies says. "Nursing truly fulfills that passion for me in caring for others."

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