Device Related Pressure Ulcers Pre and Post Identification and Intervention

Pamela Clay; Casey Cruz; Keith Ayotte; Jeremy Jones; Susan B Fowler

doi:10.1016/j.pedn.2018.01.018

Device Related Pressure Ulcers Pre and Post Identification and Intervention

J Pediatr Nurs. 2018 Jul-Aug:41:77-79. doi: 10.1016/j.pedn.2018.01.018. Epub 2018 Feb 1.

Authors

Pamela Clay¹, Casey Cruz², Keith Ayotte³, Jeremy Jones⁴, Susan B Fowler⁵

Affiliations

¹ Wound Management Skin Team, Arnold Palmer Medical Center, Orlando, FL, United States. Electronic address: Pamela.clay@orlandohealth.org.
² Pediatric Surgery, Endoscopy, Arnold Palmer Hospital for Children, Orlando, FL, United States. Electronic address: Casey.cruz@orlandohealth.com.
³ Pediatric Surgery, Arnold Palmer Hospital for Children, Orlando, FL, United States. Electronic address: Keith.ayotte@orlandohealth.com.
⁴ Pediatric Surgery, Arnold Palmer Hospital for Children, Orlando, FL, United States. Electronic address: JeremyAPHSurgery.Jones@orlandohealth.com.
⁵ Orlando Health, United States. Electronic address: Susan.Fowler@orlandohealth.org.

PMID: 29397270
DOI: 10.1016/j.pedn.2018.01.018

Abstract

Problem: From 2014 to 2016, device related pressure injuries accounted for 62-81% of all hospital acquired pressure injuries. From January to June 2014, there were 5 BiPAP/CPAP pressure injuries noted, accounting for 3.579 injuries per 1000 ventilator days. In 2015, hospital data revealed that 26.5% of all hospital acquired pressure injuries occurred to prone surgical spine patients.

Methods: Collaborative teams including respiratory therapists and operating room staff were convened and crafted new strategies.

Interventions: Adhesive foam dressings on patient faces with BiPAP/CPAP masks and prior to orthopedic spinal surgery were used to prevent device and operating room positioning pressure injuries.

Results: From July to December 2014 there were 0 BiPAP/CPAP pressure injuries. After interventions in March of 2016 through the remainder of 2016, zero pressure injuries occurred when the adhesive foam dressings were applied to the potential pressure injury areas pre-operatively.

Conclusions: We used real time patient data to drive efforts and create a new culture in the pediatric setting that honors critical airway maintenance, operative room positioning, and preventative skin protection.