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BACKGROUND: One third of all HAPUs are medical device related pressure ulcers (MDRPUs), patients with a medical device are 2.4 times more likely to develop a pressure ulcer of any kind (Black, 2010). If MDRPUs were prevented the overall incidence and prevalence rates of HAPUs would be reduced.
METHODS: A G-tube care EBP protocol was developed. Within a hospital-wide improvement plan, this project focused on education. After a pre‐test, in-service training on the new protocol was delivered to ICU nurses. To assess the effectiveness of knowledge transfer, a post ‐test was included in the training experience. A secondary review of MDRPU quality reports was also completed.
RESULTS: Identical pre- and post tests were administered consisting of eight questions with a total possible score of 16, total sample size N=81 (pre-test n=75, post-test n= 81). The data was analyzed using a t-test. On average, participants knowledge related to MDRPU was lower on the pre-test (M=11.28, SE=.332) compared to the post-test (M=14.56, SE=.172). The difference was statistically significant t (154) =-8.94, p<.05.
Secondary impacts of the project include: 1). the absence of California Department of Public Health reportable MDRPUs related HAPUs; and) 2. Increase in Wound Ostomy Nurse consults related to G-tube care.
CONCLUSION: Nursing education about the new protocol appeared to be effective and was expanded hospital wide. The development and implementation of an evidence based gastrostomy tube protocol may lead to the elimination of gastrostomy tube hospital acquired pressure ulcers. Physician preference was to routinely suture gastrostomy tubes to the skin, so a change in physician practice was required.