Skin Management and Assessment Resource Team

Saint Joseph Hospital, Chicago

Nominated by Marlene Balik, BSN, RN, CWCN

When staff members at Saint Joseph Hospital, Chicago, have questions about wound and skin care, they think SMART. They consult with the hospital's Skin Management and Assessment Resource Team (SMART).

By continually educating themselves and their colleagues on proper wound and skin management, the team has helped the hospital reduce its rate of hospital-acquired pressure ulcers from 14.3 percent 3 years ago to 2.9 percent in a recent pressure ulcer prevalence study.

The team's latest achievement is just one of the reasons this group has been selected as the 2009 ADVANCE for Nurses Best Nursing Team.

Coming Together

The team members represent the hospital's three med/surg units, three critical care units, the skilled nursing unit and the rehabilitation unit. Several units have more than one representative on the team. Rounding out the group is the med/surg nurse educator, a physical therapist and an RN quality coordinator.

"We have such an active team," said Marlene Balik, BSN, RN, CWCN, wound care nurse and team leader. "The members are the 'go-to' people on their units. They include pressure ulcer prevention and wound management in their staff meeting agendas, and they push the pressure ulcer prevention initiatives and assist their staff with wound care questions when I am not available." All of the involved units have been provided with SMART posters with a photo of that unit's wound and skin care liaison.

The group's monthly meetings have varied agendas, including guest speakers, article reviews, product reviews and testing the team's knowledge. "I have always promoted very high standards and expectations for the team and the nursing staff. We are an assertive, dynamic group, functioning cohesively and making a difference in patient care on a unit-by-unit level," Balik said. "This program also succeeds because we have the unwavering support of our hospital and nursing administration, for which our team is very grateful."

Contagious Enthusiasm

"Team members are committed to quality nursing," said Sharon Ami, RN, rehab nurse and team member. "We feed off of each other's energy."

The group counts both new and seasoned nurses among its members, and this helps create a dynamic team. Ami, for example, has been a nurse for 3 years and joined the Wound and Skin Care Committee as soon as she began working on Saint Joseph's rehab unit. "I'm coming to learn there are so many different entities in nursing, but wound care became a passion for me," Ami said.

Balik said the new nurses' passion for wanting to make a difference can be contagious and is refreshing for experienced nurses. Nurse educator Beth Cadiz, RN, a 30-year veteran agrees. She said being on the team keeps her going. "I don't want to just be content with what I already know," she said. As the med/surg nurse educator, she can teach and reinforce protocols with the staff.

Ami said this connection has led to a strong emotional bonding of the team that translates into a strong work ethic and a sense of comfort and security in asking others for help and advice. Being comfortable communicating with one another creates a constructive experience that results in better care for patients.

Balik said she also is proud of the involvement of CNAs on the wound care team. "They are so absolutely crucial in preventing pressure ulcers. They're at the bedside all the time," Balik said.

Enthusiasm for the group has spread beyond its members. "I've had nurses call me and say, 'Can I be on your team?'" Balik said. "It's nice to see people wanting to get involved."

However, before someone is added to the group, Balik ensures they will be a good fit by asking what their motivation is for joining. Besides being motivated to learn and really enjoying wound care, she wants individuals interested in personal growth and in bringing what they learn back to their unit.

It's a difficult specialty, Balik said, and she looks for people who can inspire their colleagues to take a greater interest in proper and comprehensive wound and skin care.