scholarly journals Reducing hospital-acquired pressure injuries

2019 ◽  
Vol 8 (1) ◽  
pp. e000464
Author(s):  
Yasser K Al-Otaibi ◽  
Noura Al-Nowaiser ◽  
Arshur Rahman
Keyword(s):  
Risk Assessment ◽  
Injury Risk ◽  
Assessment Tool ◽  
P Value ◽  
Evidence Based ◽  
Improvement Project ◽  
Healthcare Improvement ◽  
Pressure Injury ◽  
Evidenced Based ◽  
Hospital Acquired

Hospital-acquired pressure injury is a common preventable condition. Our hospital is a 144-bed governmental hospital in the Kingdom of Saudi Arabia that was found to have a 7.5% prevalence of hospital-acquired pressure injury in 2016. The aim of the improvement project was to reduce the prevalence of pressure injuries in our hospital from 7.5% to below 4% by the end of 2017. Our strategy for improvement was based on the Institute for Healthcare Improvement Model for Improvement. The change strategy was based on implementing an evidence-based risk assessment tool and a bundled evidence-based pressure injury prevention (PIP) intervention termed PIP bundle. After implementing the change package, we observed a reduction in the prevalence of pressure injuries by 84% (RR 0.16;95% CI 0.07 to 0.3; p value <0.0001) over a period of 12 weeks, in addition to an improvement in the compliance of pressure injury risk assessment and PIP interventions. The use of an evidenced-based bundled approach to prevent hospital-acquired pressure injuries has resulted in a significant reduction in the rate of pressure injuries. Improvement results were sustainable. In addition, our outcome measure exhibited minimal variability.

Adopting Braden Q in the NICU to Identify Neonates at Risk of Developing Pressure Injuries

2018 ◽  
Vol 37 (5) ◽  
pp. 319-323
Author(s):  
Michelle Wacek ◽  
Margaret Ecklund
Keyword(s):  
Risk Assessment ◽  
At Risk ◽  
Injury Risk ◽  
Risk Identification ◽  
Assessment Tools ◽  
Increased Risk ◽  
Risk Assessment Tools ◽  
Pressure Injury ◽  
Vulnerable Patient ◽  
Hospital Acquired

There are numerous factors placing neonates at increased risk of developing pressure injuries while hospitalized. Prevention of hospital-acquired pressure injuries in this vulnerable patient population requires early risk identification. Unfortunately, identifying neonates who are at risk of developing pressure injuries is complicated because of the lack of pressure injury risk assessment tools validated for use in neonates. The Braden Q risk assessment scale was adopted by two NICUs within a health care system to aid in identifying neonates at risk of developing a pressure injury. Additionally, the electronic health record was adapted to assist nurses in implementation of appropriate interventions to prevent pressure injuries based on Braden Q subscores.

scholarly journals Hospital acquired pressure injury prediction in surgical critical care patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jenny Alderden ◽  
Kathryn P. Drake ◽  
Andrew Wilson ◽  
Jonathan Dimas ◽  
Mollie R. Cummins ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Model Performance ◽  
Routine Care ◽  
Predictor Variables ◽  
Classification Algorithms ◽  
Data Set ◽  
Icu Patients ◽  
Pressure Injury ◽  
Surgical Icu ◽  
Hospital Acquired

Abstract Background Hospital-acquired pressure injuries (HAPrIs) are areas of damage to the skin occurring among 5–10% of surgical intensive care unit (ICU) patients. HAPrIs are mostly preventable; however, prevention may require measures not feasible for every patient because of the cost or intensity of nursing care. Therefore, recommended standards of practice include HAPrI risk assessment at routine intervals. However, no HAPrI risk-prediction tools demonstrate adequate predictive validity in the ICU population. The purpose of the current study was to develop and compare models predicting HAPrIs among surgical ICU patients using electronic health record (EHR) data. Methods In this retrospective cohort study, we obtained data for patients admitted to the surgical ICU or cardiovascular surgical ICU between 2014 and 2018 via query of our institution's EHR. We developed predictive models utilizing three sets of variables: (1) variables obtained during routine care + the Braden Scale (a pressure-injury risk-assessment scale); (2) routine care only; and (3) a parsimonious set of five routine-care variables chosen based on availability from an EHR and data warehouse perspective. Aiming to select the best model for predicting HAPrIs, we split each data set into standard 80:20 train:test sets and applied five classification algorithms. We performed this process on each of the three data sets, evaluating model performance based on continuous performance on the receiver operating characteristic curve and the F1 score. Results Among 5,101 patients included in analysis, 333 (6.5%) developed a HAPrI. F1 scores of the five classification algorithms proved to be a valuable evaluation metric for model performance considering the class imbalance. Models developed with the parsimonious data set had comparable F1 scores to those developed with the larger set of predictor variables. Conclusions Results from this study show the feasibility of using EHR data for accurately predicting HAPrIs and that good performance can be found with a small group of easily accessible predictor variables. Future study is needed to test the models in an external sample.

scholarly journals Inter-Rater Reliability of a Pressure Injury Risk Assessment Scale for Home Care: A Multicenter Cross-Sectional Study

2020 ◽  
Vol Volume 13 ◽  
pp. 2031-2041
Author(s):  
Masushi Kohta ◽  
Takehiko Ohura ◽  
Kunio Tsukada ◽  
Yoshinori Nakamura ◽  
Mishiho Sukegawa ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Home Care ◽  
Injury Risk ◽  
Cross Sectional Study ◽  
Assessment Scale ◽  
Sectional Study ◽  
Cross Sectional ◽  
Rater Reliability ◽  
Pressure Injury

scholarly journals Implementing Hospital-Acquired Pressure Injury (HAPI) Prevention Program

2020 ◽  
pp. 1-51
Author(s):  
Marisa Raynaldo
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Acute Care ◽  
Injury Severity ◽  
Evidence Based ◽  
Care Hospital ◽  
Preventive Program ◽  
Moisture Management ◽  
Pressure Injury ◽  
Hospital Acquired

Practice Problem: Hospital-Acquired Pressure Injury (HAPI) is a serious problem in patient care and has deleterious implications for the patient and the healthcare system. A 530-bed acute care hospital in the Rio Grande Valley identified a similar challenge and implemented a HAPI preventive program. PICOT: This evidence-based practice (EBP) project was guided by the following PICOT question: In the Intensive Care Unit/Medical Intensive Care Unit (ICU/MICU) patients aged 18 and older, does a pressure preventive bundle, compared to routine pressure injury care, reduce the incidence of pressure injury, within 21 days? Evidence: The reviewed literature supported evidence of effective use of a pressure injury preventive bundle in reducing the incidence of pressure injuries in an acute care setting. Seven articles met the inclusion criteria and were used for this literature review. Intervention: The evidence-based pressure injury preventive bundle are interventions that included consistent skin risk assessment and the application of a group of clinical practice guidelines composing of moisture management, optimizing nutrition and hydration and minimizing pressure, shear, and friction that were proven to prevent the occurrence of pressure injuries. Outcome: Post-implementation findings showed that there was no reduction in the incidence of HAPI but significant decrease in the severity of the pressure injury from Stage two to Stage one. Conclusion: The staff education, training, and implementation of an evidence-based bundle intervention to prevent the incidence of HAPI proved a positive outcome on reducing the pressure injury severity from Stage Two pressure injuries to Stage One pressure injuries.

Evidence-Based Fall Risk Assessment Tool

2017 ◽  
Author(s):  
Miki Higaonna ◽  
Maki Enobi ◽  
Shizuka Nakamura
Keyword(s):  
Risk Assessment ◽  
Fall Risk ◽  
Assessment Tool ◽  
Risk Assessment Tool ◽  
Evidence Based ◽  
Fall Risk Assessment

Objective Pressure Injury Risk Assessment Using A Wearable Pressure Sensor

2019 ◽  
Author(s):  
Sam Mansfield ◽  
Sachin Rangarajan ◽  
Katia Obraczka ◽  
Hanmin Lee ◽  
David Young ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Pressure Sensor ◽  
Injury Risk ◽  
Pressure Injury

scholarly journals NSQIP Impacts Patient Experience

2018 ◽  
Vol 7 (1) ◽  
pp. 89-95
Author(s):  
Maria Castaldi ◽  
Geena George ◽  
Pamela Turner ◽  
John McNelis
Keyword(s):  
Risk Assessment ◽  
Decision Making ◽  
Shared Decision Making ◽  
Patient Experience ◽  
Assessment Tool ◽  
Shared Decision ◽  
Patient Centered ◽  
Improvement Project ◽  
National Quality ◽  
Venous Thromboembolic Events

National Quality Improvement Project (NSQIP) semiannual reports (SARs) revealed high observed to expected ratios for venous thromboembolic events (VTEs) on the surgical service. Press Ganey scores identified an area of particular weakness in shared decision-making in patient care. Patients reported little to no participation in shared decision-making. A performance improvement project was developed with a 2-fold objective: decrease the percentages of patients sustaining VTE through adequate screening and prophylaxis (VTEP) and to engage patients in shared decision-making to accept VTEP through enhanced patient-centered discussions and education on the risks and benefits of VTEP. A clinical pathway was developed to implement VTEP using a standardized risk assessment tool. Patient-centered discussion introduced VTEP and impact on perioperative safety. Results included telephone survey, NSQIP SARs, and Press Ganey patient experience survey. Using NSQIP data and a pathway developed for both VTE risk assessment and patient engagement, the authors observe immediate improvements in patient experience and decreased rates of VTE.

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