Abstract: Assessing and Monitoring Interface Pressure in Intensive Care Improves Patient Care (49th Annual Conference (May 19-23, 2017))

Shannon Glavaz, MSN, RN, CWOCN, Wound Care, Pomona Valley Hospital Medical Center, Pomona, CA and Andrea Cordek, BSN, RN, CWOCN, Wound Care, Pomona Valley Hospital Medical Center, pomona, CA

Purpose

Pressure injury prevention guidelines state that patients need to be repositioned so pressure is redistributed.¹ Studies show that Health Care Providers (HCPs) are naïve of the actual pressure redistribution effects of their repositioning interventions due to turning blind. This allows patients continued exposure to high pressures² leading to pressure injury (PI) development.

Methods

Intensive Care Unit (ICU) patients are at higher risk for developing pressure injuries.³ So, all ICU mattresses were equipped with real-time pressure monitoring (RTPM) systems for 3 months. An evaluation was done to measure the effectiveness in identifying patients’ exposure to high pressure areas and to assess if interventions were able to lower high pressures to decrease PIs. The RTPMs gave HCPs a visual image of pressures under patients and monitor those pressures continuously. HCPs used pressure images to effectively reposition patients, manage appropriate settings on beds, and utilize the alerts to turn patients by their individually determined turn schedules.

Results

HCPs found the RTPMs easy to use. High pressures were decreased through interventions and interventions monitored to ensure patients were not exposed to high pressures throughout their stay. Peak pressures were recorded on 15 random patients. The HCPs repositioned patients, first without looking at the image and then looking at the image to make additional small adjustments to the patients’ positions using micro-shifting and adjusting air in the mattresses. Peak pressures ranged from 50-148 mmHg, with an average of 78 mmHg when the RTPM was not utilized for positioning. When the RTPM was utilized for positioning, peak pressures ranged from 27-49 mmHg, with an average of 38 mmHg. No new pressure ulcers occurred when the RTMPs were utilized over 3 months.

Conclusion

Pressure monitoring allowed HCPs to monitor support surface performance and employ improved pressure redistributing interventions to enhance patient outcomes in pressure injury prevention.