Location
Virtual
Start Date
1-3-2024 8:00 AM
End Date
1-3-2024 3:30 PM
Keywords:
oregon; psvmc
Description
Purpose: This quality improvement (QI) project aims to improve the accuracy and effectiveness of skin assessments for patients with darker skin tones in preventing hospital-acquired pressure injuries (HAPIs) by implementing an evidence-based, standardized skin assessment protocol and training program.
Background: Nursing staff play a vital role in preventing HAPIs. Nearly 2.5 million patients develop HAPIs annually in the United States increasing their risk of prolonged hospitalization, increased readmission, infections, and severe pain. Preventing HAPIs continues to be top priority in acute care facilities. Recent audits at a large urban Pacific Northwest hospital revealed high HAPI rates with a staff nurse knowledge gap regarding skin assessment tools. While the Braden Scale is widely used for skin assessments aimed at preventing HAPIs, it was developed primarily for lighter-skinned populations, leading to inaccuracies in assessing darker skin tones. This disparity in skin assessment practices has serious implications resulting in delayed identification, prevention, and treatment of HAPIs, more severe injuries in individuals with darker skin. Previous research has shown implementing culturally sensitive care practices, utilizing appropriate assessment tools, improving communication and collaboration among healthcare teams can help reduce pressure injuries in individuals with darker skin tones.
Methods: This quality improvement project followed the Plan-Do-Study-Act (PDSA) cycle model, with the development of an updated, evidence-based skin assessment protocol. An interdisciplinary committee with wound care specialists, skin care educators, staff development specialists and nursing staff are developing a comprehensive skin assessment protocol that addresses dark-pigmented skin patients' unique needs and challenges. An investigator-developed survey designed to explore nurse perceptions, knowledge, confidence, and beliefs about assessing dark skin tones was conducted electronically. Subsequently, a training program based on those results and the new protocol is being created collaboratively with staff development and skin care specialists using Knowles Best Practices in Adult Education. Nursing staff will receive education on accurately assessing the skin of high-risk individuals, particularly those with darker skin tones. A mixed methods approach will be used to collect quantitative and qualitative data, including HAPI incidence rates and staff knowledge assessments. Quantitative data such as HAPI rates and Likert-scale pre-and post-training nurse survey responses will be analyzed using descriptive statistics. Qualitative survey responses will be analyzed using thematic analysis.
Outcomes: This project is in progress with data analysis and findings dissemination expected by March 2024. HAPIs, the rate of occurrence of pressure injury, is calculated for each hospital unit and the overall facility. There are two types of measures, the prevalence, and incidence of pressure injuries. The prevalence is the percentage of patients with pressure injuries, the incidence is the percentage of people who developed a complication after facility admission.
Conclusion: This QI project addresses a critical healthcare disparity by attempting to improve skin assessment practices for individuals with darker skin tones, ultimately reducing HAPIs and promoting equitable care.
Implications for Practice: Successful outcomes may enhance patient safety and reduce HAPIs while addressing disparities in skin assessment among dark-pigmented patients.
Recommended Citation
Chase, Ma Fe; Scott, Travis; Hoeskel, Renee; and Rodriquez, Yolanda, "A Quality Improvement Project to Reduce Hospital Acquired Pressure Injuries in Patients with Darker Pigmented Skin" (2024). Providence Nursing Research Conference 2023 – Present. 3.
https://digitalcommons.providence.org/prov_rn_conf_annual/2024/posters/3
Department
Nursing
Department
Quality
Included in
A Quality Improvement Project to Reduce Hospital Acquired Pressure Injuries in Patients with Darker Pigmented Skin
Virtual
Purpose: This quality improvement (QI) project aims to improve the accuracy and effectiveness of skin assessments for patients with darker skin tones in preventing hospital-acquired pressure injuries (HAPIs) by implementing an evidence-based, standardized skin assessment protocol and training program.
Background: Nursing staff play a vital role in preventing HAPIs. Nearly 2.5 million patients develop HAPIs annually in the United States increasing their risk of prolonged hospitalization, increased readmission, infections, and severe pain. Preventing HAPIs continues to be top priority in acute care facilities. Recent audits at a large urban Pacific Northwest hospital revealed high HAPI rates with a staff nurse knowledge gap regarding skin assessment tools. While the Braden Scale is widely used for skin assessments aimed at preventing HAPIs, it was developed primarily for lighter-skinned populations, leading to inaccuracies in assessing darker skin tones. This disparity in skin assessment practices has serious implications resulting in delayed identification, prevention, and treatment of HAPIs, more severe injuries in individuals with darker skin. Previous research has shown implementing culturally sensitive care practices, utilizing appropriate assessment tools, improving communication and collaboration among healthcare teams can help reduce pressure injuries in individuals with darker skin tones.
Methods: This quality improvement project followed the Plan-Do-Study-Act (PDSA) cycle model, with the development of an updated, evidence-based skin assessment protocol. An interdisciplinary committee with wound care specialists, skin care educators, staff development specialists and nursing staff are developing a comprehensive skin assessment protocol that addresses dark-pigmented skin patients' unique needs and challenges. An investigator-developed survey designed to explore nurse perceptions, knowledge, confidence, and beliefs about assessing dark skin tones was conducted electronically. Subsequently, a training program based on those results and the new protocol is being created collaboratively with staff development and skin care specialists using Knowles Best Practices in Adult Education. Nursing staff will receive education on accurately assessing the skin of high-risk individuals, particularly those with darker skin tones. A mixed methods approach will be used to collect quantitative and qualitative data, including HAPI incidence rates and staff knowledge assessments. Quantitative data such as HAPI rates and Likert-scale pre-and post-training nurse survey responses will be analyzed using descriptive statistics. Qualitative survey responses will be analyzed using thematic analysis.
Outcomes: This project is in progress with data analysis and findings dissemination expected by March 2024. HAPIs, the rate of occurrence of pressure injury, is calculated for each hospital unit and the overall facility. There are two types of measures, the prevalence, and incidence of pressure injuries. The prevalence is the percentage of patients with pressure injuries, the incidence is the percentage of people who developed a complication after facility admission.
Conclusion: This QI project addresses a critical healthcare disparity by attempting to improve skin assessment practices for individuals with darker skin tones, ultimately reducing HAPIs and promoting equitable care.
Implications for Practice: Successful outcomes may enhance patient safety and reduce HAPIs while addressing disparities in skin assessment among dark-pigmented patients.
Comments
A Quality Improvement Project: Reducing Hospital Acquired Pressure Injuries in Patients with Darker Pigmented Skin
Mafe Chase BSN, RN - Travis Scott, DNP, RN, NPD-BC - Renee Hoeksel, PhD, RN - Yolanda Rodriguez, DNP, ARNP, FNP-BC
Email: mafe.chase@providence.org
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