Amanda B. Fischbein is Nurse Practitioner, Electrophysiology Group, Lexington Cardiology, 2728 Sunset Blvd #300, West Columbia, SC 29169 (
AACN Adv Crit Care. 2023 Mar 15;34(1):16-23. doi: 10.4037/aacnacc2023806.
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.
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.
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.
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.
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.
重症监护病房（ICU）的患者发生医院获得性压疮（HAPI）的比率最高。在美国，HAPI 的治疗费用估计每年为 91 亿至 116 亿美元，每位患者的总住院费用平均增加 10708 美元。除了经济影响外，压疮还会对患者的身体、社交和心理造成负面影响，并与发病率和死亡率的增加有关。
某 ICU 在一个财年内发生了 42 例 HAPI，其中 45%与未遵守机构既定循证皮肤护理方案有关。该项目旨在提高对该方案的依从性，从而降低该单位 HAPI 的发生率。
这项质量改进计划采用了循证多方面干预措施，以提高对皮肤护理方案的依从性。通过审查病历来确定一般皮肤护理方案的依从性，并衡量该单位每月 HAPI 的发生率。
该单位的 HAPI 数量从干预前的 33 例减少到干预后的 11 例，减少了 67%。在干预结束时，一般皮肤护理方案的依从率高达 76%。
使用循证多方面干预措施可以提高 ICU 对皮肤护理方案的依从性，从而降低 HAPI 的发生率，改善患者的预后。
