Pressure injury prevention in adult critically ill patients: best practice implementation project

JBI Evid Implement. 2023 Sep 1;21(3):218-228. doi: 10.1097/XEB.0000000000000352.

Abstract

Objective: This study assessed compliance with the best practices for pressure injury prevention among ICU patients at a tertiary hospital in São Paulo, Brazil.

Introduction: Intensive care patients are at high risk of developing a pressure injury; preventing this requires a best practice protocol.

Method: This best practice implementation project was conducted in a Brazilian tertiary hospital in three phases following the JBI Model of Evidence-based Healthcare. Ten criteria derived from the best available evidence were audited and monitored before and after best practice implementation.

Results: The baseline and follow-up audits evaluated 28 patients at each step. A total of 448 h of care were analyzed using a monitoring camera and medical records. Compliance with all 10 audited criteria increased, with a 50% reduction in the prevalence of pressure injuries in intensive care. Of the 223 employees, 71% claimed to have some knowledge of pressure injury prevention, and 66% reported adequate adherence to prevention protocols.

Conclusion: The audit and feedback strategy improved compliance with the criteria. Future audits are needed to promote the sustainability of evidence-based practice.

MeSH terms

  • Adult
  • Brazil
  • Critical Care
  • Critical Illness
  • Crush Injuries*
  • Evidence-Based Practice
  • Humans
  • Pressure Ulcer* / prevention & control