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Specialty Linens and Pressure Injuries in High-Risk Patients in the Intensive Care Unit.

Regi Freeman¹, Andrew Smith², Sharon Dickinson²

¹Regi Freeman is a clinical nurse specialist in the cardiovascular intensive care unit, Samuel and Jean Frankel Cardiovascular Center, University of Michigan Health System, and a member of the clinical adjunct faculty, University of Michigan School of Nursing, Ann Arbor, Michigan. Andrew Smith is a staff nurse in the cardiovascular intensive care unit, Samuel and Jean Frankel Cardiovascular Center, Sharon Dickinson is a clinical nurse specialist in the surgical intensive care unit, and Candace Friedman is a senior project manager, Office of Clinical Safety, University of Michigan Health System, Ann Arbor, Michigan. Dana Tschannen is a clinical associate professor, vice chair of the Department of Systems, Population and Leadership, and director of the post-Master's DNP program, and Shandra James is a clinical assistant professor, University of Michigan School of Nursing, Ann Arbor, Michigan. colthorp@med.umich.edu.

American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses

|November 3, 2017

Summary

Specialty linens significantly reduced pressure injuries in intensive care units. This intervention, by managing microclimate, friction, and shear, decreased posterior pressure injury rates in high-risk patients.

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Area of Science:

Medical Device Technology
Patient Safety Research
Critical Care Medicine

Background:

Intensive care units (ICUs) exhibit high rates of unit-acquired pressure injuries.
Patients in cardiovascular and surgical ICUs possess multiple risk factors for pressure injuries.
Previous interventions to minimize pressure injuries yielded limited success.

Purpose of the Study:

To assess the impact of specialty linens on pressure injury rates in high-risk ICU patients.
Specialty linens, designed with a silklike fabric, aim to optimize the patient microclimate.
The linens address key factors contributing to pressure injuries: friction, shear, moisture, and heat.

Main Methods:

A retrospective electronic health record review was conducted.
Data were compared for 9 months pre-implementation and 10 months post-implementation of specialty linens.
Specialty linens were utilized in 24 cardiovascular ICU beds and 20 surgical ICU beds, including sheets, underpads, gowns, and pillowcases.

Main Results:

Overall unit-acquired pressure injury rates decreased from 7.7% to 5.3%.
Posterior pressure injury rates (coccyx, sacrum, back, buttock, heel, spine) significantly reduced from 5.2% to 2.8% (P < .001).
The intervention demonstrated a statistically significant reduction in pressure injury development.

Conclusions:

Specialty linens effectively mitigate pressure injury development by managing microclimate, friction, and shear.
The use of specialty linens complements standard pressure injury prevention techniques.
Implementing specialty linens is a viable strategy to prevent pressure injuries in high-risk ICU populations.