Reduction of Hospital Acquired Pressure Ulcers in the Intensive Care Unit

Abstract

Topic.

Reduction of Hospital acquired sacral pressure ulcers in the Intensive Care Unit.

Discussion

Hospital acquired pressure ulcers (HAPU) in the Intensive Care Unit, (ICU) are thought to be a result of critical care. Even with an aggressive policy and practice our ICU-sacral HAPU 24 month rate was 13.6%.

 Purpose

To determine if a soft silicone dressing could decrease the incidence of sacral HAPU in the ICU.

Methodology

For 30 months skin care representatives examined all patients in the ICU for HAPU during monthly skin checks. Sacral HAPU incidence prior to the dressing implementation was 13.6%. In February the IRB Board granted approval to apply a soft silicone dressing to all patients sacrum in the ICU as a preventative measure. Patient’s sacral areas were examined twice daily. Patients that were excluded from the study were those who could turn and toilet independently. The sacral HAPU rate calculated after implementation of the soft silicone dressing was a rolling rate rather than a monthly one.

A total of 273 patients in the ICU were enrolled in the study lasting for six months, ranging in age from 18 to 105 years.

Results.

With the subject population of 273 patients the sacral pressure ulcer rate decreased to 1.8%. Five patients developed sacral pressure ulcers. Of these five patients three developed suspected deep tissue injuries and subsequently expired. The remaining two patients developed stage 2 pressure ulcers.

Conclusion   During the study period we were able to reduce the sacral HAPU rate in our ICU from 13.6% to 1.8%. It is concluded that sacral HAPU’s might be caused from factors other than pressure.  The soft silicone dressing in combination with pressure ulcer practices might decrease the sacral HAPU’s in the ICU setting.

Disclosure

No financial assistance was obtained to complete this study.