A QI Project to Reduce the Incidence of Pressure Injuries in the Acute Care Older Adult Patient During a Pandemic
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Authors
Meysenburg, Evan
Issue Date
2022-05-12
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Abstract
Practice Problem: A pressure injury (PI) develops secondarily to inadequate tissue perfusion to an area of the body. PIs remain a detrimental component to the healthcare system. As of 2008, the Centers for Medicare and Medicaid no longer reimburse facilities for pressure injuries staged greater than two. PIs are painful to the patient and complicate their management. Specifically, patients in the acute care facility are more prone to impaired mobility and often require the use of medical devices known to impair tissue perfusion. Older adults in the acute care setting are at highest risk for PIs because of changes in their integumentary system, a decline in their compensatory mechanisms, and other co-morbidities complicating their treatment and outcomes. This population requires emphasized preventative measures to reduce the PI rates that hinder facility reimbursement and patient quality of life.|PICOT: The PICOT question developed for this quality improvement project is as follows: Will staff compliance with an 8-week PI prevention bundle reduce the incidence of pressure injuries in the older adult acute care population?|Evidence: Current EBPs suggest the use of PI prevention bundles consisting of 3-5 interventions that are to be completed at routine and frequent intervals. Providing education to the participants within the study as well as auditing their interventions has shown to improve compliance rates.|Intervention: A facility-driven PI prevention bundle was initiated within the telemetry unit for 8 weeks. These results were compared to the pre-implementation PI incidence rates. Data analysis also provided insight to the causative agents behind adherence rates with the bundle. All core RN and CNAs were provided with education regarding PIs and the prevention bundle. Weekly auditing was maintained to assess compliance with the bundle.|Outcome: Compliance with the bundle was poor. Further data within the study identified the added stressors placed upon staff throughout the pandemic to be the cause.|Conclusion: Continued auditing, in addition to surveillance, is necessary to enhance recognition of PI incidences within the unit. This data will provide an opportunity to grow stakeholder investment and initiate the implementation of PI prevention to the facility’s list of quality indicators.
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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