Reducing hospital-acquired pressure injuries

Abstract

Hospital-acquired pressure injury is a common preventable condition. Our hospital is a 144-bed governmental hospital in the Kingdom of Saudi Arabia that was found to have a 7.5% prevalence of hospital-acquired pressure injury in 2016. The aim of the improvement project was to reduce the prevalence of pressure injuries in our hospital from 7.5% to below 4% by the end of 2017. Our strategy for improvement was based on the Institute for Healthcare Improvement Model for Improvement. The change strategy was based on implementing an evidence-based risk assessment tool and a bundled evidence-based pressure injury prevention (PIP) intervention termed PIP bundle. After implementing the change package, we observed a reduction in the prevalence of pressure injuries by 84% (RR 0.16;95% CI 0.07 to 0.3; p value <0.0001) over a period of 12 weeks, in addition to an improvement in the compliance of pressure injury risk assessment and PIP interventions. The use of an evidenced-based bundled approach to prevent hospital-acquired pressure injuries has resulted in a significant reduction in the rate of pressure injuries. Improvement results were sustainable. In addition, our outcome measure exhibited minimal variability.

Characteristics of Hospital Acquired Pressure Ulcer and Factors Affecting Its Development: A Retrospective Study

“…Across the Middle East, the prevalence of a PU is estimated to be 7-44.4% [ 3 , 4 ]. Previous research has been conducted in a 144-bed governmental hospital in Saudi Arabia, and they have found that the prevalence of hospital-acquired PU was 7.5% [ 5 ].…”

Effect of Preventive Bundle Guidelines on Nurses’ Knowledge and Compliance Regarding Pressure Ulcer Among Critically Ill Children at Pediatric Intensive Care Unit

“…Total scores range from (9-18) scores with 9 or less than 9 putting a child at the highest risk for skin ulcer and more than 18 with no risk. The scores of all items were summed-up and divided as the following: severe risk (9 or below) high risk (10)(11)(12), moderate risk (13)(14) mild risk (15)(16)(17)(18) and no risk (more than 18) scores.…”

“…Interventions include pressure relief, specialized mattresses, dressing over bony prominences, monitoring devices, nutritional support and use of skin moisturizers. Moreover, the strategy for preventing pressure ulcer relies on two interdependent domains: pressure ulcer risk identification and pressure ulcer risk mitigation [10].…”

Application of the educational method of realistic simulation in the treatment of pressure injuries

“…National and international guidelines indicate that simple preventive measures must be reinforced daily, such as: change of position at scheduled times, use of materials and therapies to provide pressure relief, predictive scales, adequate nutritional support, use of dressings, maintenance of the patient's and bed's hygiene, and health education not only for professionals, but also for family members (5)(6)(12)(13)(14) . The main concern of the clinical simulation scenarios is to ensure that the professional reproduces aspects of reality in an interactive and dynamic way, and also reflects on the solutions of care problems based on scientific evidence, so that the simulation promotes a positive impact for the clinical practice (15)(16)(17) .…”

“…The main concern of the clinical simulation scenarios is to ensure that the professional reproduces aspects of reality in an interactive and dynamic way, and also reflects on the solutions of care problems based on scientific evidence, so that the simulation promotes a positive impact for the clinical practice ( 15 - 17 ) .…”