Universal Pressure Ulcer Prevention Bundle With WOC Nurse Support.

Area of Science:

• Critical Care Medicine
• Nursing Science
• Patient Safety Research

Background:

• Pressure ulcers pose a significant risk to intensive care unit (ICU) patients, increasing morbidity and healthcare costs.
• Standard pressure ulcer prevention guidelines often rely on reactive, referral-based interventions.
• Proactive, integrated prevention strategies are needed to improve patient outcomes in high-risk settings.

Purpose of the Study:

• To evaluate the effectiveness of a universal pressure ulcer prevention bundle (UPUPB) combined with proactive, semiweekly wound, ostomy, and continence (WOC) nurse rounds.
• To compare the UPUPB intervention with standard care regarding adherence to evidence-based interventions and pressure ulcer incidence.
• To assess the impact of a structured prevention program on unit-acquired pressure ulcers in ICU patients.

Main Methods:

• A quasi-experimental, pre- and postintervention design was employed across three ICUs.
• Data included skin assessments, chart reviews for adherence to five key interventions, and WOC nurse rounding logs.
• Multivariate logistic regression analysis was used to determine the intervention's effect on pressure ulcer incidence, controlling for covariates.

Main Results:

• The incidence of unit-acquired pressure ulcers decreased significantly from 15.5% to 2.1%.
• Adherence to heel elevation and repositioning interventions showed statistically significant improvement.
• The UPUPB intervention demonstrated a significant reduction in pressure ulcer incidence, with the model explaining 39.6% of the variance.

Conclusions:

• The UPUPB, when integrated with proactive WOC nurse rounds, led to a statistically significant and clinically relevant reduction in pressure ulcer incidence.
• This comprehensive prevention strategy enhanced adherence to critical interventions and improved patient safety in the ICU.
• The findings support the implementation of bundled, proactive nursing interventions for effective pressure ulcer prevention.