Reducing hospital acquired pressure ulcers in intensive care

Abstract

Pressure ulcers are a definite problem in our health care system and are growing in numbers. Unfortunately, it is usually the most weak and vulnerable of our culture that faces these complications, causing the patient and their families discomfort, anguish, and economic hardship due to their expensive treatment.Data collected by the tissue viability department showed high incidence of hospital acquire pressure ulcers in the intensive care unit in March 2013. An action plan was initiated and implemented by the tissue viability team, senior nursing management, pressure ulcer prevention (PUP) team and respiratory therapists (RT's) within the ICU. Our objective was to reduce hospital acquired pressure ulcers in the intensive care unit using the plan, do, check, act quality improvement process.

Vitamin D Status Is Associated With Development of Hospital‐Acquired Pressure Injuries in Critically Ill Surgical Patients

“…Typically formed on areas of the body vulnerable to long periods of compression, soft‐tissue damage is a result of locally impaired microcirculation and subsequent tissue hypoxia and ischemia . It is estimated that ≤40% of patients develop pressure injuries during their ICU hospitalization, an outcome that is often seen as a reflection of inadequate hospital‐based care . In a secondary analysis of data from a recent multicenter study (n = 7291), ICU patients were 3.8 times more likely to develop a HAPI compared with those not admitted to the ICU (relative risk 3.8; 95% CI 2.7–5.4) .…”

“…Although several interventions, guidelines, and risk assessment tools are available to clinicians to potentially aid in the prevention of pressure injuries, the incidence and cost of HAPIs continues to increase . Indeed, ICU patients continue to demonstrate the highest incidence and prevalence of pressure injuries when compared with the total hospital population .…”

“…Indeed, ICU patients continue to demonstrate the highest incidence and prevalence of pressure injuries when compared with the total hospital population . Although inadequate ancillary care is reasoned to be a major cause of pressure injury formation, it is important to note that pressure injuries are remarkably complicated, multifactorial, chronic wounds with physiologically impaired wound healing . Unlike acute wounds, pressure injuries do not complete the distinct phases of wound repair, described as inflammation, proliferation, remodeling, and maturation .…”

Measuring the quality of pressure ulcer prevention: A systematic mapping review of quality indicators

“…Worldwide, pressure ulcers (PUs) are regarded as a major unwanted and mostly preventable harm in health care . Despite substantial research activities in the field, various quality improvement initiatives, and policies to enhance patient safety, “zero incidence” is unlikely to be achieved in the near future.…”

Improving the quality of pressure ulcer management in a skilled nursing facility

“…Together with the prevalence ranges reported by Cuddigan et al, these data indicate that the prevalence of PUs can be reduced. Changes in management practice and procedures can have a significant impact on improving quality metrics: use of an abbreviated daily review checklist/“bookmark” over two Plan‐Do‐Study‐Act (PDSA) cycles resulted in improvements in their completion rates in a general intensive care unit; this extends to hospital‐acquired PUs in an intensive care setting . Improvements in documentation can play a vital role in wound management: increasing the clarity of record of care using a transfer sticker system documenting date, time, location, and plan of care to be implemented for assessed PUs can reduce the number of avoidable hospital‐acquired PUs .…”