Abstract: The Effect of a Dynamic Alternating Micropressure Overlay in High Risk Cardiac Surgical Patients to Reduce Pressure Injuries (WOCNext 2019)

Sunday, June 23, 2019: 2:34 PM

Joy Pittman, PhD, ANP-BC, FNP-BC, CWOCN¹, Karrie Bailey, RN², Terrie Beeson, MSN RN CCRN ACNS-BC³, Deb Hall, BSN, RN, CNOR⁴, Dawn Horvath, MSN, RN, ACNS-BC, CNS-BC⁵, Laura Kaiser, RN, CNOR⁴, Emily Meister, BSN, RN, CCRN-CSC⁵, Anna Mills, MSN, RN⁵ and Jennifer Sweeney, MSN, RN, ACNS-BC, CDE², (1)Wound Ostomy Continence, Indiana University Health, Indianapolis, IN, (2)Indiana University Health- Academic Health Center, Indianapolis, IN, (3)Indiana University Health, University Hospital, Indianapolis, IN, (4)Surgery, Indiana University Health- Academic Health Center, Indianapolis, IN, (5)Nursing, Indiana University Health- Academic Health Center, Indianapolis, IN

Hospital-acquired pressure injuries (HAPI) continue to occur especially in critical care patients. HAPI rates were highest in our critically ill cardiothoracic patients and were Operating Room (OR)-related. A new dynamic micropressure overlay (DMO) designed for OR and critical care to prevent pressure injuries was identified as a potential prevention strategy. The purpose of our study was to examine the effect of this DMO on HAPI in the cardiothoracic patient.

Using a pre/post comparative design, a DMO was placed on OR and critical care surfaces of patients who had prolonged cardiovascular procedures and/or extracorporeal membrane oxygenation, Ventricular Assist Device, and/or Heart or Lung transplant. Data collected included: HAPI rates, related costs and staff satisfaction. Descriptive statistics were used to summarize data.

Our results demonstrated a reduction of OR-related HAPI over 6 months from 8/71 (8.5%) to 0/147 (0%). This resulted in a OR-related HAPI cost avoidance of $368,000 (HAPI X 8 @ $46,000); when annualized, $1,472,000 cost avoidance is projected. OR staff satisfaction surveys demonstrated positive results with a mean of 3.85 (1-4). In Critical Care, 12% (8 /7) HAPI incidence reduction was noted and incidence density decreased from 3.57 to 3.24. No improvement in HAPI monthly prevalence was noted in critical care over the 6 months. However, during the 6 months there were many high-acuity patients in the unit which did not meet inclusion criteria thus influencing the prevalence rates. Staff satisfaction mean was 2.95 (1-4) but staff preferred the overlay compared to the usual care (fluid emersion) surface. A cost savings of 22% was found in critical care using the DMO compared to usual care.

The findings of this study suggest a reduction of HAPI’s and cost savings can be realized utilizing the DMO. This intervention offers an additional pressure injury prevention option for the immobile patient undergoing surgery.

GS04 The Effect of a Dynamic Alternating Micropressure Overlay in High Risk Cardiac Surgical Patients to Reduce Pressure Injuries