"Implementing a Hospital-Acquired Pressure Ulcer Intervention in the IC" by Audrey Gross

Document Type

DNP Project

Department

School of Nursing

Date of Degree

2021

Degree

Doctor of Nursing Practice (DNP)

Primary Advisor

Dr. Mercedes Echevarria; Dr. Elzbieta Kmiecik

Keywords

Hospital-Acquired Pressure Ulcers (HAPUs); Intensive Care Unit (ICU)

Abstract

Background: Hospitals had been confronting greater incentives to prevent Hospital-Acquired Pressure Ulcers (HAPUs). HAPU rates had increased in the Intensive Care Unit (ICU) at an academic hospital over the past six months, especially regarding device related HAPUs.

Objectives: The primary purpose of this project’s implementation was to decrease the number of HAPUs in the ICU by 50% within a three-month timeframe. Secondary objectives were to achieve scores of 100% in terms of compliance with the Registered Nurse (RN) education module, post-test scores, and documentation.

Methods: This was a Quality Improvement (QI) project involving adult patients in the ICU of an academic hospital. A five-step model for HAPU prevention called SSKIN was implemented and expanded to SSKIN’D to include devices. This involved 1-month of pre-intervention data collection, implementation of the SSKIN’D educational intervention, and 1-month of post-intervention data collection via documentation audits.

Results: There were more HAPUs in the post-intervention period relative to the pre-intervention period (13 vs. 12). The number of HAPUs per 1,000 ICU patient days declined between the pre- and post-intervention periods, from 12.6 to 11.2. Only 63.9% of RNs ultimately received the SSKIN’D training.

Conclusions: The analysis showed the incidence of HAPUs was not statistically different before and after the intervention (p = 0.77). Not all RNs having received the SSKIN’D education may have contributed to the limited observed clinical impact of the intervention. Other major limitations to this project included the COVID-19 pandemic, a malware attack, and a lack of consistent staffing.

Open Access

1

Included in

Nursing Commons

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