Loading...
Recommended Citation
Olson J, Anzia K. Pink Paper for Pressure Injury Reduction. Quality Improvement podium presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.
Presentation Notes
Quality Improvement podium presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.
Abstract
Background: Hospital acquired pressure injury (HAPI) prevention can be challenging in acute care hospital settings, requiring systematic application of individualized evidence-based prevention measures. Adverse effects of HAPI include increased pain, risk for infection, and extended length of stay for patients, and substantial cost and quality concerns for hospitals.
Local Problem: Pressure Injury Prevalence (PIP) surveys in 2022 identified 38 stage 2 or greater HAPI at a 162-bed tertiary care hospital. During the first 6 months of 2023, there were 22, reflecting an increasing trend.
Method: A quality improvement project using Plan-Do-Study-Act (PDSA) framework was developed by the wound care Professional Governance team. After review of organizational best practices and discussion of published literature, the team collaborated with inpatient nurses and leadership to integrate expert knowledge through implementation the Pink Paper Project. Wound care nurses reviewed admission Braden scores and stratified patients into categories, allowing for workflow prioritization to address patients at greatest risk for skin breakdown. A pink paper reminder was posted in the patient’s room to cue patients and nurses of the increased risk for pressure injury and associated interventions.
Results: During the 9-month period from June 2023 through March 2024, 840 patients qualified for the project, 794 participated, and 30 developed a HAPI. Baseline PIP survey rates for HAPI stage 2 and above published by NDNQI were 4.29 and 2.60 for the first two quarters of 2023. Following implementation, the rate continued to decrease, most recently 0.98 in the fourth quarter of 2023. The downward trend has continued into 2024, with zero stage 2 or greater HAPI identified during April and May PIP surveys.
Implications for Practice: A proactive approach to interdisciplinary teamwork and screening yielded increased collaboration across the nursing team and sharing of expert knowledge and responsibility for pressure injury prevention.
References:
Al-Otaibi, Y. K., Al-Nowaiser, N., & Rahman, A. (2019). Reducing hospital-acquired pressure injuries. BMJ Open Quality, 8(e000464). https://doi.org/10.1136/bmjoq-2018-000464
Latimer, S., Chaboyer, W., Thalib, L., McInnes, E., Bucknall, R., & Gillespie, B. M. (2019). Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalization. Journal of Clinical Nursing, 28(21-22), 4119-4127. https://doi.org/10.1111/jocn.14967
Shieh, D.C., Berringer, C. M., Pantoja, R., Resureccion, J., Rainbolt, M. J., & Hokoki, A. (2018). Dramatic reduction in hospital-acquired pressure injuries using a pink paper reminder system. Advances in Skin & Wound Care, 31(3), 118-122.
Wyatt, R. (2022). Reducing hospital-acquired pressure injuries through measure-vention. Advances in Skin & Wound Care, 35(1), 43-47. https://10.1097/01.ASW.0000801528.2103.88
Document Type
Oral/Podium Presentation
Publication Date
11-13-2024
Pink Paper for Pressure Injury Reduction
Background: Hospital acquired pressure injury (HAPI) prevention can be challenging in acute care hospital settings, requiring systematic application of individualized evidence-based prevention measures. Adverse effects of HAPI include increased pain, risk for infection, and extended length of stay for patients, and substantial cost and quality concerns for hospitals.
Local Problem: Pressure Injury Prevalence (PIP) surveys in 2022 identified 38 stage 2 or greater HAPI at a 162-bed tertiary care hospital. During the first 6 months of 2023, there were 22, reflecting an increasing trend.
Method: A quality improvement project using Plan-Do-Study-Act (PDSA) framework was developed by the wound care Professional Governance team. After review of organizational best practices and discussion of published literature, the team collaborated with inpatient nurses and leadership to integrate expert knowledge through implementation the Pink Paper Project. Wound care nurses reviewed admission Braden scores and stratified patients into categories, allowing for workflow prioritization to address patients at greatest risk for skin breakdown. A pink paper reminder was posted in the patient’s room to cue patients and nurses of the increased risk for pressure injury and associated interventions.
Results: During the 9-month period from June 2023 through March 2024, 840 patients qualified for the project, 794 participated, and 30 developed a HAPI. Baseline PIP survey rates for HAPI stage 2 and above published by NDNQI were 4.29 and 2.60 for the first two quarters of 2023. Following implementation, the rate continued to decrease, most recently 0.98 in the fourth quarter of 2023. The downward trend has continued into 2024, with zero stage 2 or greater HAPI identified during April and May PIP surveys.
Implications for Practice: A proactive approach to interdisciplinary teamwork and screening yielded increased collaboration across the nursing team and sharing of expert knowledge and responsibility for pressure injury prevention.
References:
Al-Otaibi, Y. K., Al-Nowaiser, N., & Rahman, A. (2019). Reducing hospital-acquired pressure injuries. BMJ Open Quality, 8(e000464). https://doi.org/10.1136/bmjoq-2018-000464
Latimer, S., Chaboyer, W., Thalib, L., McInnes, E., Bucknall, R., & Gillespie, B. M. (2019). Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalization. Journal of Clinical Nursing, 28(21-22), 4119-4127. https://doi.org/10.1111/jocn.14967
Shieh, D.C., Berringer, C. M., Pantoja, R., Resureccion, J., Rainbolt, M. J., & Hokoki, A. (2018). Dramatic reduction in hospital-acquired pressure injuries using a pink paper reminder system. Advances in Skin & Wound Care, 31(3), 118-122.
Wyatt, R. (2022). Reducing hospital-acquired pressure injuries through measure-vention. Advances in Skin & Wound Care, 35(1), 43-47. https://10.1097/01.ASW.0000801528.2103.88
Affiliations
Aurora Medical Center Grafton