Department of Nursing Education and Professional Development, Lenox Hill Hospital, New York, New York.
Intensive Care, Medical-Surgical, Rehabilitation, NYC Health and Hospitals, Metropolitan, New York, New York.
Wound Manag Prev. 2020 Oct;66(10):20-28.
Patients in critical care units (CCUs) are at risk of the development of hospital-acquired pressure injuries (HAPIs). Research supports the use of a pressure injury prevention (PIP) bundle to standardize PIP strategies and reduce the incidence of HAPIs.
This evidence-based practice initiative was undertaken to implement a PIP bundle to decrease HAPIs in an adult patient CCU.
A literature review was conducted during the first month of the implementation of the initiative to identify best PIP and bundle implementation practices. Wound, ostomy, and continence nurses conducted educational sessions and mentored registered nurses who became PIP bundle resource nurses. Adoption of the bundle was validated using an audit tool and PIP rounds. The pre- and post-implementation HAPI indices, pressure injuries / patient care days × 1000, were compared.
Implementation of the PIP bundle resulted in a notable decrease in HAPIs on the unit. During the pre-intervention period, January 2017 to January 2018, there were 9 HAPIs (HAPI index 3.4). During the 10-month post-intervention period, 1 HAPI developed (HAPI index 0.48).
An evidence-based PIP bundle initiative was implemented in an adult patient CCU to standardize the process for HAPI prevention and reduce the number of HAPIs. Staff involvement and leadership support were vital to the success of the initiative. Integration of the bundle into practice resulted in a notable decrease in HAPIs.
本循证实践计划旨在实施预防压力性损伤（PIP）包，以降低成人患者 CCU 中的压力性损伤发生率。
在实施该计划的第一个月进行了文献回顾，以确定最佳的 PIP 和捆绑实施实践。伤口、造口和失禁护士进行了教育课程，并指导成为 PIP 捆绑资源护士的注册护士。使用审核工具和 PIP 查房来验证捆绑的采用情况。比较了实施前后的压力性损伤发生率（压力性损伤/患者护理天数×1000）。
实施 PIP 包显著降低了该单位的压力性损伤发生率。在干预前期间，即 2017 年 1 月至 2018 年 1 月，发生了 9 例压力性损伤（压力性损伤发生率 3.4）。在干预后的 10 个月期间，发生了 1 例压力性损伤（压力性损伤发生率 0.48）。
在成人患者 CCU 中实施了一项基于证据的 PIP 捆绑计划，以规范压力性损伤预防流程并降低压力性损伤发生率。员工参与和领导层支持对该计划的成功至关重要。将捆绑包纳入实践中显著降低了压力性损伤的发生率。
