Teacher's PPET: Developing a Pediatric Pictorial Education Tool to Reduce Medical Device Related Pressure Ulcers

PURPOSE: Medical device related (MDR) pressure ulcers (PrU) are documented as >50% in the pediatric intensive care population1. A recent study shows hospitalized adult patients with medical devices are 2-4 times more likely to develop a PrU2. Variables thought to play a role in development of MDR PrU include:

• Pressure from a medical device

• Moisture at the device/skin interface (microclimate)

There is currently no “accepted” definition of a MDR PrU, thus we propose this definition:

Pressure ulcers caused when medical devices place unrelieved pressure against soft tissue resulting in loss of blood flow (ischemia) to an area, this may be accompanied by the presence of moisture, shear and/or friction.

OBJECTIVE: Develop a pediatric pictorial education tool (PPET) using soft silicone foam dressings (SiFoam) for prevention of MDR PrU.

METHODS:

• Literature review of:

     o MDR PrU

     o Prophylactic use of dressings for PrU prevention

• Informal interview conducted with multidisciplinary pediatric wound care practitioners to determine:

     o Need for the tool

     o Common locations of pediatric MDR PrU

• Collaboration with an inpatient skin committee whose formulary includes use of SiFoam

RESULTS:

• Literature review demonstrated SiFoam is effective in decreasing PrU incidence, in adults, when used to manage friction, shear and moisture3

o 2009 NPUAP guidelines state: “Consider placing foam dressings on body areas and pressure ulcers at risk for shear injury “4

• Identification of common locations for pediatric MDR PrU

• Development of PPET with SiFoam for prophylactic use

• Implementation of PPET by skin committee

CONCLUSION: A pediatric education tool demonstrating prophylactic use of soft silicone foam dressings for MDR PrU has the potential to; impact staff recognition of MDR PrU, promote appropriate preventive interventions, improve patient comfort and reduce the incidence pediatric medical device related PrU.