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Purpose: Reduction of Hospital Acquired Pressure Injuries (HAPU’s), and correction of practice deficits regarding prevention of pressure injuries. The WOC nurse was notified of all hospital acquired pressure injuries starting in November of 2013. 2014 Prevalence study showed a HAPU rate of 6.5%. Upon investigation, high risk patients were not receiving evidence based nursing interventions, there was not a formal pressure injury prevention program in place. There was a knowledge deficit regarding the relationship of low Braden subset scores and specific nursing interventions. High risk patients were on regular foam mattresses. OR acquired Pressure injuries were increasing. Operating Room table pads were thin, vinyl covered foam, and were 16 years old. Shearing forces injured deep tissues.
Objective: Create a multidisciplinary team to correct knowledge, practice, and equipment deficits, and the creation of a comprehensive Pressure Injury Prevention Program.
Summary: Hospital acquired pressure injuries called for a hospital wide campaign to correct deficits, and change our culture from treatment only, to prevention of pressure injuries.
Results: Staff attended the PUPS Training in September, 2015. New 4” OR pads, Air beds, seating cushions, heel lifts, and 5 layer foam prevention dressings were purchased. Educational resource materials were distributed to all units. HAPU’s decreased from 6.5% in 2014, to 1.2% in 2016. Exclusion of Stage 1 pressure injuries resulted in 0% HAPU’s for 2016. The American Journal of Surgery estimates the cost of healing a stage 4 pressure injury to be about $129,000.00 (Brem,Maggi,Nierman,Rolnitzky,Bell,Rennert,Golinko,Yan,Lyder, & Vladdeck, 2004). Eight of the twenty HAPU’s from 2014 were Deep Tissue Injuries, which can open to stage 4 injuries, even with optimal care. Estimated cost savings preventing these injuries is $1,032,000.00.