Reducing Pressure Injuries in Critically Ill Patients by Using a Patient Skin Integrity Care Bundle (Inspire)

Coyer, Fiona; Gardner, Anne; Doubrovsky, Anna; Cole, Rae Leigh; Ryan, Frances; Allen, Craig H.; McNamara, Greg

doi:10.4037/ajcc2015930

Cited by 77 publications

(140 citation statements)

References 26 publications

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123

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“…The hospital has sustained a "zero zone" incidence among adults and pediatric patients for PrUs overall, receiving a top performing, "Clinical Excellence Award" from CALNOC (the California Collaborative Alliance for Nursing Outcomes), for the past 3 years. Coyer reported that systematic and ongoing assessment of the patient's skin and risk for pressure injuries as well as implementation of tailored prevention measures are central to preventing pressure injuries in the critically ill. 26 Visscher et al found similar results through the use of a team; the PrU rate in the PICU was 14.3/1,000 patient-days during the QI development and 3.7/1,000 patient-days after QI implementation (P<.05), achieving the aim of 50% reduction. The PICU rates of stages 1, 2, and 3 conventional and device-related PrUs also decreased after the QI intervention.…”

supporting

confidence: 56%

Medical device-related pressure ulcers

Black¹,

Kalowes²

2016

CWCMR

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Pressure ulcers from medical devices are common and can cause significant morbidity in patients of all ages. These pressure ulcers appear in the shape of the device and are most often found from the use of oxygen delivery devices. A hospital program designed to reduce the number of pressure ulcers from medical devices was successful. The program involved the development of a team that focused on skin, the results were then published for the staff to track their performance, and it was found that using foam dressings helped reduce the pressure from the device. The incidence of ulcers from medical devices has remained at zero at this hospital since this program was implemented.

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supporting

confidence: 56%

Medical device-related pressure ulcers

Black¹,

Kalowes²

2016

CWCMR

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“…Most of the studies that measured PI prevalence in acute and non‐acute health care facilities also reported on PI staging . The majority of PIs in these studies were at Stage I (non‐blanchable erythema only).…”

Section: Resultsmentioning

confidence: 99%

“…Several papers on PIs reported incidence . These papers measured incidence over a variety of time periods, from 7 days to 12 months .…”

Section: Resultsmentioning

confidence: 99%

Chronic wounds in Australia: A systematic review of key epidemiological and clinical parameters

McCosker

Tulleners

Cheng

et al. 2018

International Wound Journal

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Chronic wounds are a significant problem in Australia. The health care‐related costs of chronic wounds in Australia are considerable, equivalent to more than AUD $3.5 billion, approximately 2% of national health care expenditure. Chronic wounds can also have a significant negative impact on the health‐related quality of life of affected individuals. Studies have demonstrated that evidence‐based care for chronic wounds improves clinical outcomes. Decision analytical modelling is important in confirming and applying these findings in the Australian context. Epidemiological and clinical data on chronic wounds are required to populate decision analytical models. Although epidemiological and clinical data on chronic wounds in Australia are available, these data have yet to be systematically summarised. To address these omissions and clarify the state of existing evidence, we conducted a systematic review of the literature on key epidemiological and clinical parameters of chronic wounds in Australia. A total of 90 studies were selected for inclusion. This paper presents a synthesis of the evidence on the prevalence and incidence of chronic wounds in Australia, as well as rates of infection, hospitalisation, amputation, healing, and recurrence.

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“…L a i m p l e m e n t a c i ó n d e p r o g r a m a s d e mejora continua de la calidad, que incluyan l a c a p a c i t a c i ó n d e l p e r s o n a l , l a m e j o r a de la comunicación, la identificación de los pacientes con mayor riesgo de padecer UPP y la estandarización de los procedimientos de atención y cuidado, ha demostrado disminuir la incidencia de UPP. 3,12,15,16,19 En pediatría, hay pocos estudios publicados en los cuales se implemente un paquete de medidas para reducir la incidencia de UPP. Entre ellos, se encuentra el de Visscher y col., 3 quienes reportaron una disminución de la incidencia de UPP del 50% (pre-: 14,3 x 1000 pacientes/día; pos-: 3,7 x 1000 pacientes/día, p < 0,05) luego de la aplicación de un programa de mejora de la calidad que incluía la evaluación frecuente de la piel, educación y empoderamiento del personal.…”

Section: Discussionunclassified

“…Coyer y col., 19 en una UCI de Australia, reportaron menor número de UPP por paciente y un desarrollo más tardío de estas durante la internación en la UCI.…”

Section: Discussionunclassified