How can Photographic/Thermographic Imaging be used as an adjunctive measure with Skin Prevention Care Bundles in ICU to help decrease FAPI’s (Facility Acquired Pressure Injuries)

Purpose:  Improve quality of care for our patients in the ICU by initiating Prevention Care Bundles, which would include, on Admission Head-to-Toe and 4-Eyes Skin Assessment,
obtaining a photographic/thermal image of common pressure injury sites and then Implementing additional interventions to prevent skin breakdown.

Subjects:  Adult population in the combined Medical/Surgical/Cardiac ICU’s.

Method:  Upon admission to any ICU bed, Head-to-Toe 4-Eyes Skin Assessment and Braden score were completed. A Photographic/Thermal imaging device was utilized to obtain a visual/thermal image pair of the most common areas of pressure and skin breakdown, which were identified as the sacrococcogeal area and bilateral heels. If patients presented with a Hx of being “found down”, area of concern was also scanned. Images were then analyzed by the WOC RN’s. If any skin anomaly was identified, additional interventions were put into place.

Results: After a successful trial in 2016, the Photographic/Thermographic device was purchased. In March 2018, implementation of a Prevention Skin Care Bundle was initiated in ICU with thermal imaging integrated completely in July 2018. Between August 1, 2018 and October 1, 2018, 190 patients were scanned and images analyzed. 148 areas showed s/s of Deep Tissue Injury as reflected by at least a -2.0 degree Celsius or +2 degree Celsius anomaly of intact skin. Interventions were put in place to assist in preventing the manifestation of partial or full-thickness skin loss. No progression to Stage 2 or greater Pressure Injury occurred to any of our patients. Photographic/Thermographic Imaging will continue to be utilized in ICU and hopefully expand to include other areas of the hospital.