Innovations in Pressure Injury Reporting: Creating Actionable Data for Improvement

Polancich, Shea; Williamson, Jason; Poe, Terri; Armstrong, Amy; Noot, Ross M. Vander

doi:10.1097/jhq.0000000000000196

Cited by 9 publications

(13 citation statements)

References 3 publications

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“…The HAPI analytical tool was built by an improvement team within the hospital to collect staged pressure injury attribution assigned by the Wound, Ostomy, and Continence (WOC) Team. 25 These HAPI data are considered the most accurate attribution of staging and are stored within the HAPI analytical tool managed by the hospital finance department. These data are identified by the date of attribution in the month when the injury is acquired and connected to the ICD-10 data for the month of discharge.…”

Section: Methodsmentioning

confidence: 99%

Learning During Crisis: The Impact of COVID-19 on Hospital-Acquired Pressure Injury Incidence

Polancich¹,

Hall²,

Miltner³

et al. 2021

J Healthc Qual

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The impact of COVID-19, on the health and safety of patients, staff, and healthcare organizations, has yet to be fully uncovered. Patient adverse events, such as hospital-acquired pressure injuries (HAPIs), have been problematic for decades. The introduction of a pandemic to an environment that is potentially at-risk for adverse events may result in unintended patient safety and quality concerns. We use the learning health system framework to motivate our understanding of the impact of the COVID-19 pandemic on the incidence of HAPIs within our health system. Using a retrospective, observational design, we used descriptive statistics to evaluate trends in HAPI from March to July 2020. Hospital-acquired pressure injury numbers have fluctuated from a steady increase from March–May 2020, hitting a peak high of 90 cases in the month of May. However, the trend in the total all stage HAPIs began to decline in June 2020, with a low of 51 in July, the lowest number since March 2020. Patients evaluated in this study did not have a longitudinal increase in HAPIs from March–July 2020 during the COVID-19 pandemic, despite similarities in illness severity between the two time points. Our experience has demonstrated the ability of our organizational leaders to learn quickly during crisis.

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Section: Methodsmentioning

confidence: 99%

Learning During Crisis: The Impact of COVID-19 on Hospital-Acquired Pressure Injury Incidence

Polancich¹,

Hall²,

Miltner³

et al. 2021

J Healthc Qual

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“…Longer lengths of stay in the ICU and AIR may contribute to delay of acute care hospitals to discharge their patients and increased healthcare costs. For example, in 2019, Padula et al estimated that US hospitalacquired pressure injuries cost $10,708 per patient, and the U.S. had a national average of 2.5 million reported cases, potential costing $26.8 billion annually (33). The COVID-19 pandemic was an unprecedented challenge to the healthcare system as a whole in terms of resource and staff availability (36).…”

Section: Resultsmentioning

confidence: 99%

“…After noting a steady increase of pressure injuries during the first surge (March to May 2020), Polancich et al observed that prone placement was a significant risk factor for pressure injury development. Thus, they were able to implement interventional strategies, such as placing silicon adhesive dressings on pressure points on the prone patients ( 34 , 35 ). One such set of recommendations adapted for the care of COVID-19 patients in the acute care setting is summarized in Tables 6 , 7 , so that similar pandemic surges in the future will have decreased pressure injury incidence ( 36 – 39 ).…”

Section: Discussionmentioning

confidence: 99%

Pressure injury prevalence and characteristics in patients with COVID-19 admitted to acute inpatient rehabilitation unit

Bloom

Rathgeber

et al. 2023

Front. Rehabil. Sci.

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ObjectiveTo investigate the incidence and severity of pressure injuries among COVID-19 patients who required acute hospitalization and subsequent acute inpatient rehabilitation (AIR).DesignData was collected retrospectively from medical charts of COVID-19 patients who were admitted to AIR during April 2020–April 2021.SettingAcute Inpatient Rehabilitation at a single hospital in the greater New York metropolitan area.ParticipantsSubjects included COVID-19 patients (N = 120) who required acute hospitalization and subsequent acute inpatient rehabilitation, of whom 39 (32.5%) had pressure injuries.InterventionsNot applicable.Main outcome measure(s)The incidence, location, and severity of pressure injuries in COVID-19 patients, as well as demographic and clinical characteristics of the acute hospitalization.ResultsAmong patients who developed pressure injuries, more patients received mechanical ventilation (59% vs. 33%, P < 0.05) and tracheostomy (67% vs. 17%, P < 0.00001). The lengths of stay were longer in both the intensive care unit (ICU) (34 vs. 15 days, P < 0.005), and in acute inpatient rehabilitation (22 vs. 17 days P < 0.05).ConclusionPressure injuries were more common in COVID-19 patients who had longer lengths of stay, received mechanical ventilation or tracheostomy, during acute hospitalization. This supports the use of protocols to prioritize pressure offloading in this patient population.

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“…Administrative, demographic, and HAPI data were collated into an Excel spreadsheet from our hospital billing system and our internal HAPI analytic tool. 17 , 18 Patient demographic data were collected via a data steward using patient identifiers but were de-identified prior to analysis and provision to the study principal investigator.…”

Section: Methodsmentioning

confidence: 99%

Modeling Patient Risk for Hospital-Acquired Pressure Injuries During COVID-19

Montgomery

Patrician

Hall

et al. 2021

Journal of Nursing Care Quality

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Background: COVID-19 negatively impacts many organ systems including the skin. One of the most significant skin-associated adverse events related to hospitalization are pressure injuries. Purpose: The aim of this study was to determine 8 risk factors that would place hospitalized patients at a higher risk for hospital-acquired pressure injuries (HAPIs) during the COVID-19 pandemic. Methods: A retrospective, descriptive analysis was conducted in an urban academic health science center located in the southeastern United States. Results: There were 247 of 23 093 patients who had pressure injuries and 1053 patients who had a positive COVID-19 diagnosis. Based on the generalized estimating equation model, diagnosis of COVID-19, age, male gender, risk of mortality, severity of illness, and length of stay are statistically significant factors associated with the development of HAPIs. Conclusions: Further study should explore pathology of COVID-19 skin changes and what interventions are effective against HAPIs in the COVID-19 population taking into consideration current treatments.

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Innovations in Pressure Injury Reporting: Creating Actionable Data for Improvement

Cited by 9 publications

References 3 publications

Learning During Crisis: The Impact of COVID-19 on Hospital-Acquired Pressure Injury Incidence

Learning During Crisis: The Impact of COVID-19 on Hospital-Acquired Pressure Injury Incidence

Pressure injury prevalence and characteristics in patients with COVID-19 admitted to acute inpatient rehabilitation unit

Modeling Patient Risk for Hospital-Acquired Pressure Injuries During COVID-19

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