Pressure Injury Prevention Algorithm in the Intensive Care Setting
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Authors
Petsch, Carmen
Issue Date
2023-05-11
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Abstract
Purpose: The purpose of this quality improvement project is to determine the impact of a pressure injury prevention algorithm to decrease the incidence of pressure injuries in an Intensive Care Unit.
Background: Pressure injuries are a prevalent problem in hospitals, they negatively affect patient outcomes and increase financial burden.
Sample/Setting: The setting was a medical/surgical ICU and a trauma ICU in Omaha, Nebraska. The sample included patients aged 19 and above that were admitted to either the medical/surgical or trauma ICU. 160 patient charts were audited on the medical/surgical ICU, and 63 patient charts were audited on the trauma ICU.
Methods: This project is based on a quality improvement project theoretical framework with the implementation of a practice intervention design. A pressure injury prevention algorithm was implemented and adherence to the algorithm was monitored. Also, the incidence of pre-implementation pressure injuries was compared to post-implementation pressure injuries.
Results: In the medical/surgical ICU 73% of all nurses and 29% of all CNAs, and in the trauma ICU 74% of all nurses and 30% of all CNAs were educated on the pressure injury prevention algorithm. In the medical surgical ICU 98% of patients received a Braden score within 4 hours of admission, 86% of patients had a Braden score performed every shift, 34% of patients were turned every 2 hours, 51% of patients received a waffle overlay, 0% had Allevyn dressings placed, and 12% had Prevalon boots placed. In the trauma ICU of 98% patients received a Braden score within 4 hours of admission, 97% of patients had a Braden score performed every shift, 17% of patients were turned every 2 hours, 30% of patients received a waffle overlay, 0% had Allevyn dressings placed, and 0% had Prevalon boots placed. The pre-implementation data indicated a pressure injury rate of 54% over a 4-week period and 25% over a separate 4-week period in the medical/surgical ICU, and a 6% pressure injury rate over a 4-week period and a 36% pressure injury rate over a separate 4-week period in the trauma ICU. The post-implementation data showed an 8% pressure injury rate over an 8-week period in the medical/surgical ICU, and a 0% pressure injury rate over an 8-week period.
Conclusion: Pressure injury prevention measures on not being implemented on a consistent basis. However, the pressure injury rates decreased in both of the ICUs in the post-implementation period compared to the pre-implementation period.
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Creighton University
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University