Document Type

Presentation

Publication Date

2024

Keywords

california; sjho; orange

Abstract

Background:

The patient population in Medical Intensive care units (MICU) have the highest risk of developing pressure injuries. These pressure injuries can be attributed from medical devices such as Endotracheal tubes, nasogastric tubes, chest tubes etc. Diligent care and assessment of skin is crucial upon admission. Aggressive measures need to be implemented early through prevention protocols, the Air-tap turning system, appropriate bed education, placement of foams/Z-flex boots on arrival to unit. Appropriate staff education will help ensure policies are being initiated early on and decrease hospital acquired pressure injuries.

Purpose:

The Medical Intensive Care Unit (MICU) has seen a gradual increase in hospital acquired pressure injuries (HAPIs) and Device related hospital acquired pressure injuries. The purpose of this project was to provide nurses with education on an appropriate pressure injury prevention step, early initiation of advanced skin care tips, appropriate support surface for patient hospital stays, and education on nutritional supplements that can be initiated to help wound healing and prevent skin breakdown.

Methods:

This project was an evidence-based QI project. The setting was a twenty bed Medical Intensive Care unit. The unit consisted of intubated/non-intubated critical patients. The project stemmed from an increase in staff education through written/verbal instructions on pressure ulcer/medical device related pressure injury prevention. It also included staff education on the implementation of an Air-tap Turning system. The collaboration with dietary on nutritional supplements education for staff was also formulated. The data was collected through eight chart audits per month and monitoring prevalence and incidence quarterly for areas of improvement needed.

Results:

The dates of January 2024-July 2024 revealed a decrease in the amount of Hospital acquired pressure injuries except for May, there was a slight increase. However, compared with the data from January 2023-July 2023 the results varied. The Device related hospital acquired pressure injuries varied and there was no significant trend.

Conclusion:

Quarterly prevalence and incidence revealed areas in need of improvement. Frequent chart audits help to ensure policies are being followed and indicate areas that may need improvement. Educational resources need to be available for staff to access. Some key limitations that were faced during this project were the influx of new staff. Progressa plus low air loss beds provided for all patients will help ensure patients are on appropriate beds. Reeducation of Air-tap turning system, prevention protocols, appropriate times to consult nutrition and wound care and nutrition supplements should be done annually.

Implications for practice:

Annual education needs to be implemented to ensure policies are being followed. This education needs to include appropriate skin interventions to follow, updates on prevention policies, and new products.

Specialty

Critical Care Medicine

Specialty

Nursing

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