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Atrium Health Floyd

Presentation Notes

Quality Improvement poster presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.

Abstract

Background: A hospital-acquired pressure injury is localized damage or injury to the skin and/or underlying tissue that typically occurs over a bony prominence or in relation to medical devices during an inpatient hospital stay. This preventable condition is one of the biggest challenges facing healthcare organizations due to the high costs associated with treatment and no reimbursement from payors.

Local Problem: The prevention of pressure injuries in an adult medical and surgical Intensive Care Unit setting is particularly challenging due to the patients’ complex needs. From December 2022 – April 2023, the 26-bed Intensive Care Unit had 27 hospital-acquired pressure injuries, or an average of 5.4 per month.

Method: By utilizing an A3 tool, Critical Care leadership team partnered with their bedside clinicians and Wound Care team to implement a Turn Team to ensure consistent repositioning and turning of the critically ill patient.

The Turn Team consists of three designated certified nursing assistants tasked to turn/reposition every patient, every two hours alongside the patient’s primary nurse. The Turn Team is responsible for documenting the care provided and submitting the documentation to the unit manager. The bedside clinicians worked together to evaluate and redistribute their daily tasks.

Results/Conclusions: Since implementation of the Turn Team in May 2023, there have been four hospital-acquired pressure injuries. The Intensive Care Unit reduced the mean from 5.4 hospital-acquired pressure injuries per month to 0.364 hospital-acquired pressure injuries per month, which is a statistically significant change as demonstrated by a Two-Sample T test with a p-value equal to 0.000.

Implications for Practice: Pressure injury prevention is the focus, and these changes have been sustained for a year. The clinical practice is every patient in the Intensive Care Unit is repositioned six times during a 12-hour shift. The results and clinician collaboration has been the catalyst for creating a hospital-wide pressure injury prevention task force.

Document Type

Poster

Publication Date

11-13-2024


 

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Nov 13th, 12:00 AM

Reducing Hospital-Acquired Pressure Injury Rates in an Intensive Care Unit

Background: A hospital-acquired pressure injury is localized damage or injury to the skin and/or underlying tissue that typically occurs over a bony prominence or in relation to medical devices during an inpatient hospital stay. This preventable condition is one of the biggest challenges facing healthcare organizations due to the high costs associated with treatment and no reimbursement from payors.

Local Problem: The prevention of pressure injuries in an adult medical and surgical Intensive Care Unit setting is particularly challenging due to the patients’ complex needs. From December 2022 – April 2023, the 26-bed Intensive Care Unit had 27 hospital-acquired pressure injuries, or an average of 5.4 per month.

Method: By utilizing an A3 tool, Critical Care leadership team partnered with their bedside clinicians and Wound Care team to implement a Turn Team to ensure consistent repositioning and turning of the critically ill patient.

The Turn Team consists of three designated certified nursing assistants tasked to turn/reposition every patient, every two hours alongside the patient’s primary nurse. The Turn Team is responsible for documenting the care provided and submitting the documentation to the unit manager. The bedside clinicians worked together to evaluate and redistribute their daily tasks.

Results/Conclusions: Since implementation of the Turn Team in May 2023, there have been four hospital-acquired pressure injuries. The Intensive Care Unit reduced the mean from 5.4 hospital-acquired pressure injuries per month to 0.364 hospital-acquired pressure injuries per month, which is a statistically significant change as demonstrated by a Two-Sample T test with a p-value equal to 0.000.

Implications for Practice: Pressure injury prevention is the focus, and these changes have been sustained for a year. The clinical practice is every patient in the Intensive Care Unit is repositioned six times during a 12-hour shift. The results and clinician collaboration has been the catalyst for creating a hospital-wide pressure injury prevention task force.

 

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