Reduction of Hospital Acquired Device Related Pressure Ulcers in the Intensive Care Unit

Reduction of Hospital Acquired Device Related Pressure Ulcers in the Intensive Care Unit 

TOPIC:  Reduction of Hospital acquired Device Related Pressure Ulcers in the Intensive Care Unit.  DISCUSSION:  Intensive Care Unit (ICU) patients are critically unstable and are at high risk for developing device related hospital acquired pressure ulcers (HAPU).  PURPOSE:  To determine if a change in nursing practice, assessment and technique could decrease the incidence of device related HAPUs in the ICU.  METHODOLOGY:  The Skin Integrity ICU team consisted of the ICU Director, ICU Manager, the Champions of Skin Integrity ICU staff (CSI), ICU Respiratory Staff and the Wound, Ostomy and Continence Nurses (WOC nurses).  The team used evidenced based guidelines to identify a knowledge gap among the staff concerning skin assessment around devices and solutions to relieve device related pressure.  For seven months, the WOC nurses rounded twice a week on the most vulnerable patients in the ICU. Rounding was used as an educational opportunity to the ICU staff on assessment, NPUAP staging definitions and techniques to avoid device related HAPU.  A total of 293 patients in the ICU were involved in the study during the seven months. The CSI created a poster identifying device related pressure ulcers and appropriate treatment.  Power point presentations were given describing assessment, identification and prevention of device related pressure ulcers. Device related protocols were presented at staff meetings and administrative meetings.RESULTS: From the March prevalence to September prevalence, the device related HAPU rate decreased by 22%.CONCLUSION: Application of a collaborative approach between all disciplines with an emphasis on prevention and risk assessment will continue to decrease the incidence of device related pressure ulcers in the ICU.DISCLOSURE: No financial assistance was obtained to complete this study.