Hand-held device to decrease hospital acquired pressure injuries: from theory to practice

Rose Raizman, RN-EC, MSc, MNurs, CETN, professional practice, Rouge Valley Health System, toronto, ON, Canada and Minette MacNeil, RN, MEd, MScN, Rouge Valley Health System, Toronto, ON, Canada
Aim: To evaluate feasibility of hand-held skin tissue assessment device (the scanner) in preventing incidence of pressure injuries (PI) in the community hospital

Methodology: Phase 1: conducted to control for Hawthorne effect: When standard protocol was used without regards to scanner reading, but implementation of standard protocol was reinforced by person with scanner. Device was used to scan all newly admitted patients on medical/stroke unit for the length of stay for one month. Standard intervention protocol was implemented and no interventions were instituted according to scanner readings. Phase2: A) First 30 patients admitted to ALC unit were scanned from admission for up to 14 days and interventions were implemented based on scanner reading and standard protocol. B) First 100 newly admitted patients to the hospital were scanned from admission day for 3 days and interventions were based on scanner reading and standard protocol. Pressure ulcer development, scanner readings, standard assessment and intervention (Braden score based protocol) were recorded using data collection tool and analyzed. Data was compared to hospital historical and concurrent data.

Results:  A total of 235 patients were scanned:  Phase1- 89 patients scanned and 13.4% incidence was found.  Phase 2- 146 patients scanned and 1.3% incidence found.  Data suggests that intervention according to the scanner reading decreased incidence 10 times (90% reduction).

Conclusions: Current practice misses opportunities for early detection and early intervention that can prevent PIs. It is based on risk assessment and visual assessment of skin in areas prone to PIs. When visually evident, significant tissue damage has already occurred and opportunity for prevention is already missed. In our pilot study the scanner has been successfully used in practice to generate real-time insight to confirm early detection of tissue damage and to target interventions, leading to lower incidence, earlier recovery and lower costs of care.