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[Reducing patient pressure sore incidence density in the pediatric surgical intensive care unit]
Wei-Chen Huang1, Shiow-Ru Chang2, Chi-Min Tang3
1Pediatric Surgical Intensive Care Unit, National Taiwan University Hospital;, Taiwan, ROC.
Insights
A quality improvement program significantly reduced pressure sore incidence density in a pediatric-surgical-intensive-care unit. The intervention lowered pressure sore rates, enhancing patient care quality.
Area of Science:
- Nursing quality improvement
- Patient safety in intensive care settings
- Healthcare-associated infections prevention
Context:
- High incidence density of pressure sores (0.74%) in a pediatric-surgical-intensive-care unit exceeded benchmarks.
- Previous unit incidence density was 0.55% in 2010, indicating a worsening trend.
- The Taiwan Clinical Performance Indicator (TCPI) for medical centers was 0.62%.
Purpose:
- To decrease pressure sore incidence density from 0.74% to a target of 0.31%.
- To improve the overall quality of nursing care within the unit.
Summary:
- Implemented a multi-faceted quality improvement program including education, visual aids, reminders, specialized devices, and audits.
- Strategies focused on preventing pressure ulcer formation through improved patient positioning and care techniques.
- The program involved on-the-job training, bedside teaching, and development of illustrative materials.
Impact:
- Successfully reduced pressure sore incidence density from 0.74% to 0.18%.
- Demonstrated a significant improvement in patient outcomes and nursing care quality.
- The program's effectiveness highlights the value of systematic interventions in reducing hospital-acquired conditions.
Background & Problems:
Our unit recorded 21 cases of pressure sores from January 2011 to June 2011. The resulting pressure-sore incidence density of 0.74% exceeded the Taiwan Clinical Performance Indicator (TCPI) for medical centers (0.62%) as well as the mean incidence density for our unit (0.55%) during the same period in 2010.
Purpose:
We developed this project to decrease the incidence density of pressure sores at our pediatric-surgical-intensive-care unit from 0.74% to 0.31%.
Resolutions:
Strategies implemented included: 1. providing on-the-job education; 2. providing bedside teaching; 3. developing a series of pictures to illustrate proper sitting, lying, and changing positions and the proper fixation of catheters; 4. implementing a reminder mechanism; 5. introducing pressure-preventing devices; 6. and establishing an audit team.
Results:
Incidence density decreased from 0.74% (Jan. to Jun. 2011) to 0.18% (Mar. to Jul. 2012).
Conclusions:
We demonstrated that the developed improvement program effectively reduced the incidence density of pressure sores and increased the quality of nursing care.
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