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Title:
Identifying High Risk ICU Patients: Use of an absorbent soft silicone self-adherent bordered foam dressing to decrease pressure ulcers in the Surgical Trauma ICU patient.
Purpose:
To more effectively identify patients most at risk for breakdown in the STICU and to develop interventions to prevent pressure ulcer development.
Significance:
AtVCU Medical Center the Braden Skin Risk Scale is used for all adult patients. This risk assessment tool fails to adequately determine risk in the trauma patient population. Previous prevalence studies showed greatest PU occurrence on the sacrum and heels. It was felt that if specific interventions could reduce risk and produce positive outcomes within this group, they could be duplicated with other high risk ICU patients.
Strategy and Implementation:
A meeting was called between the CWOCN covering the Surgical Trauma ICU (STICU), the unit’s Clinical Educator, and staff nurses. The team chose risk factors thought to pose the greatest significance for this patient population. Shear, friction and excess moisture were theorized to be major factors in skin breakdown. A topical wound care product was selected by the WOCN that was hypothesized to decrease these risks. A bedside tool to identify “high risk” ICU patients was developed jointly between the CWOCN and staff. If patients met identified criteria, the product was applied to intact skin and skin checks were completed each shift. Patients were tracked in the STICU for a period of 2 months.
Evaluation:
During a 2 month evaluation with more than fifty patients identified for inclusion, no pressure ulcers developed on individuals who had an absorbent soft silicone foam dressing applied prophylactically.
Implications for Practice:
It has become apparent that additional attention must be placed on identifying and addressing shear, friction and moisture concerns in the critically ill patient. Maintaining skin integrity with use of the soft silicone self adherent foam dressing may prove to be a key factor in pressure ulcer prevention in the most critically ill patients.
Identifying High Risk ICU Patients: Use of an absorbent soft silicone self-adherent bordered foam dressing to decrease pressure ulcers in the Surgical Trauma ICU patient.
Purpose:
To more effectively identify patients most at risk for breakdown in the STICU and to develop interventions to prevent pressure ulcer development.
Significance:
At
Strategy and Implementation:
A meeting was called between the CWOCN covering the Surgical Trauma ICU (STICU), the unit’s Clinical Educator, and staff nurses. The team chose risk factors thought to pose the greatest significance for this patient population. Shear, friction and excess moisture were theorized to be major factors in skin breakdown. A topical wound care product was selected by the WOCN that was hypothesized to decrease these risks. A bedside tool to identify “high risk” ICU patients was developed jointly between the CWOCN and staff. If patients met identified criteria, the product was applied to intact skin and skin checks were completed each shift. Patients were tracked in the STICU for a period of 2 months.
Evaluation:
During a 2 month evaluation with more than fifty patients identified for inclusion, no pressure ulcers developed on individuals who had an absorbent soft silicone foam dressing applied prophylactically.
Implications for Practice:
It has become apparent that additional attention must be placed on identifying and addressing shear, friction and moisture concerns in the critically ill patient. Maintaining skin integrity with use of the soft silicone self adherent foam dressing may prove to be a key factor in pressure ulcer prevention in the most critically ill patients.