Sacral Breakdown Prevention and Continuous Quality Improvment

Sacral Breakdown Prevention & Continuous Quality Improvement

In 2009, the hospital acquired pressure ulcer prevalence averaged 9.6% in the Critical Care Department (CCD).  The majority of these pressure ulcers were found on the sacral/coccyx area.

As pressure ulcers are an indicator of quality patient care, The WOC Nurse Team’s goal was to champion a project to reduce our hospital acquired sacral breakdown in the CCD.

After conducting a literature review, the WOC Nurse Team found research supporting the use of a five layer soft silicone adhesive sacral dressing which has been shown to manage the skin’s microclimate as well as reduce friction and shear.

The five layer soft silicone adhesive sacral dressing was trialed in the CCD in July 2009 with very positive outcomes. The Sacral Breakdown Prevention Project was approved for use in CCD in 2010 with very specific criteria. 

The average sacral pressure ulcer prevalence was 7.8% for 2010.

From 2010-2013, the dressing protocol was for the primary nurse to assess the skin under the foam dressing daily.

The outcomes were positive with a downward trend in the prevalence of sacral pressure ulcers in the CCD.

In 2014 Trident's guidelines were changed to advance the skin assessment under a prophylactic five layer soft silicone adhesive sacral dressing from daily to every three days. 

The Critical Care Department’s Pressure Ulcer Prevalence has remained below the National CCD average (4.5% in 2014) which can be attributed in part to the use of the five layer soft silicone adhesive sacral dressing.