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Development of a pressure ulcer trigger tool for the neonatal population
Bette Schumacher1, Mary Askew, Kathy Otten
1Sanford USD Medical Center, Sioux Falls, South Dakota 57110, USA. bette.schumacher@sanfordhealth.org
Insights
A neonatal intensive care unit developed a 3-question tool to identify infants at risk for pressure ulcers. This tool aids in preventing skin breakdown in vulnerable neonates.
Area of Science:
- Neonatal intensive care
- Evidence-based practice
- Skin integrity management
Background:
- Neonatal intensive care units (NICUs) face challenges in monitoring skin integrity.
- Prevalence of pressure ulcers in a Level IIIb NICU was low (0-1%) but lacked a consistent risk assessment tool.
- Existing risk assessment tools were deemed too lengthy for routine clinical use.
Purpose of the Study:
- To identify a validated risk assessment tool for pressure ulcer development in neonates.
- To develop a concise and clinically applicable tool for identifying infants at risk for pressure ulcers.
Main Methods:
- Utilized the Iowa Model for Evidence-Based Practice to guide the project.
- Conducted a literature review to identify validated pressure ulcer risk assessment instruments.
- Developed a novel, brief trigger tool consisting of three questions.
Main Results:
- A literature search did not yield a suitable, concise risk assessment tool for the NICU setting.
- A 3-question trigger tool was successfully developed to identify neonates at risk for pressure ulcers.
- The tool aims to facilitate early intervention and prevention of skin breakdown.
Conclusions:
- A short, 3-question trigger tool can effectively identify neonates at risk for pressure ulcers in the NICU.
- This tool supports evidence-based practice by providing a practical method for risk assessment.
- Implementing this tool can improve skin care protocols and patient outcomes in neonatal populations.
Abstract:
A large Midwest level IIIb neonatal intensive care unit located in a 500-bed teaching hospital implemented quarterly skin prevalence surveys to monitor prevalence of altered skin integrity including pressure ulcers, diaper dermatitis (incontinence-associated dermatitis), and skin damage as a result of intravenous therapy, adhesive, or medical devices. Pressure ulcer prevalence varied from 0% to 1% per quarter, and no pressure ulcer risk assessment tool was regularly implemented. Therefore, a working group was formed to identify a risk assessment. The Iowa Model for Evidence-Based Practice was used to guide the project. A literature review was completed to identify validated instruments, but available tools were judged lengthy for routine clinical use. Therefore, we developed a short trigger tool comprising 3 questions to identify infants at risk for pressure ulcer development.
