Wound Healing Center, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Douliu, Taiwan.
Division of Plastic and Reconstructive Surgery, Department of Surgery, National Taiwan University Hospital, Yunlin Branch, Douliu, Taiwan.
Int Wound J. 2024 Oct;21(10):e70054. doi: 10.1111/iwj.70054.
To assess a quality improvement project using alternating pressure air mattresses' impact on reducing full-thickness pressure injuries by enhancing setting accuracy and device utilization. We retrospectively evaluated adult acute care unit patients with inclusion criteria (Braden scores ≤12 or existing full-thickness pressure injuries) between May 2020 and August 2023. A wound team attempted to enhance the accuracy, utilization and effectiveness of alternating pressure air mattress implementation. The implementation outcomes were setting accuracy and accurate utilization rates. The clinical outcome was the full-thickness pressure injury proportion. Utilization and allocation gaps were also calculated. The setting accuracy and accurate utilization rates increased (0.59 to 0.88 and 0.15 to 0.37, respectively). The full-thickness pressure injury proportion decreased (0.17 to 0.06), with a strong negative correlation coefficient (-0.789) (p < 0.001) with accurate utilization rates. The full-thickness pressure injury proportion declined faster during the project's complete phase than the partial phase (-0.0046 vs. -0.0016; p < 0.05). The utilization gap narrowed (99 to 60); however, the allocation gap increased (1 to 13), suggesting increased alternating pressure air mattress usage among ineligible patients. Targeting high-risk patients for alternating pressure air mattress utilization and ensuring correct settings, both performed by a dedicated team, substantially reduces the full-thickness pressure injury incidence.
评估使用交替压力气垫床通过提高设定准确性和设备利用率来减少全层压力损伤的质量改进项目。我们回顾性评估了 2020 年 5 月至 2023 年 8 月间具有纳入标准(Braden 评分≤12 分或存在全层压力损伤)的成人急性护理病房患者。一个伤口团队试图提高交替压力气垫床实施的准确性、利用率和效果。实施结果是设定准确性和准确利用率。临床结果是全层压力损伤比例。利用率和分配差距也进行了计算。设定准确性和准确利用率增加(分别从 0.59 增加到 0.88 和从 0.15 增加到 0.37)。全层压力损伤比例降低(从 0.17 降低到 0.06),与准确利用率呈强负相关系数(-0.789)(p<0.001)。在项目的完全阶段,全层压力损伤比例下降速度比部分阶段更快(-0.0046 对-0.0016;p<0.05)。利用率差距缩小(从 99 缩小到 60);然而,分配差距增加(从 1 增加到 13),表明不合格患者中交替压力气垫床的使用增加。针对高危患者使用交替压力气垫床,并由专门的团队确保正确设置,可显著降低全层压力损伤的发生率。