The Pressure Ulcers to Zero (PUTZ) collaborative was the first large scale improvement collaborative to take place in Ireland and was supported by the Quality Improvement Division (now the National Quality Improvement Team), Health Service Executive (HSE) and the Royal College of Physicians Ireland (RCPI), through the National Quality Improvement Programme.
The initial two phases of PUTZ were a joint HSE/Royal College of Physicians in Ireland (RCPI) Collaborative. Phase 1 (2014/2015) was facilitated in the former Dublin North East Region of Ireland. Phase 2 (2015/2016) involved participation from multidisciplinary teams across the Ireland East Hospital Group, Community Healthcare Organisations 5, 6, 8, & 9 and private residential nursing homes. Phase 3 of the PUTZ collaborative was facilitated by the HSE only (2017/2018). It focused on the acute sector with an initial 23 multidisciplinary teams participating from all acute hospitals in the South South-West Hospital Group (SSWHG) and Dublin Midlands Hospital Group (DMLHG).
The teams that participated in the PUTZ collaborative became part of an active learning community, learning from each other and from recognised experts. The role of participating teams, in every phase, was to implement the SSKIN bundle which is a specific five step process that when performed collectively and reliably can improve PU prevention as it guides assessment and prompts targeted prevention strategies.
- To reduce newly acquired PUs across participating sites within determined timeframes
- To support participating teams in in using Quality Improvement approaches and developing and improving knowledge, skills and expertise in PU prevention
- To develop a learning community and network nationally which will accelerate learning and share good practice
- To promote a culture of learning and continuous improvement
Phase 1 (2014-2015)
- Joint HSE/Royal College of Physicians in Ireland (RCPI) collaborative
- Participating Teams: Former Dublin North East region – 21 multidisciplinary teams across hospitals, primary care centres, nursing homes & community /private residential centres.
- Aim: To reduce the number of avoidable PUs across participating teams by 50% within the time frame of the collaborative
- RESULT: PUTZ 1 achieved a 73% reduction in avoidable PUs
Phase 2 (2015-2016)
- HSE/RCPI Collaborative
- Participating Teams: Ireland East Group, CHOs 5, 6, 8 & 9 & private residential nursing homes – 26 multidisciplinary teams.
- Aim: To reduce the number of avoidable PUs across participating teams by 50% within the timeframe of the collaborative
- RESULT: PUTZ 2 achieved a 49% reduction in avoidable PUs
Phase 3 (2016-2018)
- HSE only
- Participating Teams: All acute hospitals in the South South-West Hospital Group and the Dublin Midlands Hospital Group – 22 teams.
- Aim: To reduce newly acquired PUs by 50% across participating teams in a six month timeframe and to sustain this reduction by twelve months (28th February 2018).
- Result: PUTZ 3 achieved a 67.5% reduction in avoidable PUs
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