Improving Skin Care Protocol Use in the Intensive Care Unit to Reduce Hospital-Acquired Pressure Injuries.

IF 2 Q2 NURSING

AACN Advanced Critical Care Pub Date : 2023-03-15 DOI:10.4037/aacnacc2023806

Amanda B Fischbein

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引用次数: 1

Abstract

Background: Patients in the intensive care unit have the highest rate of hospital-acquired pressure injuries (HAPIs). In the United States, treatment of HAPIs costs an estimated $9.1 to $11.6 billion annually, with each occurrence adding an average of $10 708 to a patient's total hospital cost. In addition to their financial impact, pressure injuries negatively affect patients physically, socially, and psychologically and are associated with increased morbidity and mortality.

Objective: An intensive care unit had 42 HAPIs during a single fiscal year, with 45% of them related to lack of adherence to the institution's established evidence-based skin care protocol. This project was conducted to increase adherence to the protocol and thus reduce the incidence of HAPIs in the unit.

Methods: This quality improvement initiative featured an evidence-based multifaceted intervention to increase adherence to the skin care protocol. A review of medical records was used to determine general skin care protocol adherence and to measure the monthly incidence of HAPIs in the unit.

Results: The number of HAPIs in the unit decreased from 33 in the preintervention period to 11 in the postintervention period, a reduction of 67%. The rate of general skin care protocol adherence improved to as high as 76% by the end of the postintervention period.

Conclusion: Use of an evidence-based multifaceted intervention can improve adherence to a skin care protocol in the intensive care unit, resulting in a reduced incidence of HAPIs and improved patient outcomes.

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改善重症监护室皮肤护理方案的使用以减少医院获得性压力损伤。

背景:重症监护病房患者的医院获得性压力损伤(HAPIs)发生率最高。在美国，每年治疗HAPIs的费用估计为91亿至116亿美元，每发生一次，患者的总住院费用平均增加10708美元。除了经济上的影响外，压力伤害还会对患者的身体、社会和心理产生负面影响，并与发病率和死亡率增加有关。目的:一个重症监护室在一个财政年度有42例HAPIs，其中45%与缺乏对该机构已建立的循证皮肤护理方案的遵守有关。本项目旨在提高对方案的依从性，从而降低该单位hapi的发生率。方法:这一质量改善倡议的特点是基于证据的多方面干预，以增加对皮肤护理方案的依从性。对医疗记录进行回顾，以确定一般皮肤护理方案的依从性，并测量该单位中hapi的月发生率。结果:该单位hapi数量由干预前的33个减少到干预后的11个，减少了67%。一般皮肤护理方案的依从率在干预期结束时提高到高达76%。结论:采用基于证据的多方面干预可以提高重症监护室对皮肤护理方案的依从性，从而降低HAPIs的发生率并改善患者预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

AACN Advanced Critical Care NURSING-

CiteScore

2.10

自引率

4.50%

发文量

期刊介绍： AACN Advanced Critical Care is a quarterly, peer-reviewed publication of in-depth articles intended for experienced critical care and acute care clinicians at the bedside, advanced practice nurses, and clinical and academic educators. Each issue includes a topic-based symposium, feature articles, and columns of interest to critical care and progressive care clinicians. AACN Advanced Critical Care contains concisely written, practical information for immediate use and future reference. Continuing education units are available for selected articles in each issue. AACN Advanced Critical Care is an official publication of the American Association of Critical-Care Nurses.