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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.
Background:
The cardiovascular and surgical intensive care units had the highest unit-acquired pressure injury rates at an institution. Patients in these units had multiple risk factors for pressure injuries. Various interventions had been used to minimize pressure injuries, with limited results.
Objectives:
To evaluate the effect of specialty linens on the rate of pressure injuries in high-risk patients. The specialty linen was a synthetic silklike fabric that addressed the microclimate surrounding the patient, with the purpose of minimizing friction, shear, moisture, and heat.
Methods:
The specialty linen was tried on 24 beds in the cardiovascular intensive care unit and 20 beds in the surgical intensive care unit, including sheets, underpads, gowns, and pillow cases. Data obtained from a retrospective review of electronic health records were compared for 9 months before and 10 months after specialty linens were implemented.
Results:
Total unit-acquired pressure injury rates for both units combined declined from 7.7% (n = 166) before to 5.3% (n = 95) after the intervention. The intervention was associated with a significant reduction in posterior (coccyx, sacrum, back, buttock, heel, and spine) pressure injury rates, from 5.2% (n = 113) before to 2.8% (n = 51) after specialty linens were implemented (P < .001).
Conclusion:
Addressing the microclimate, friction, and shear by using specialty linens reduces the number of posterior pressure injuries. The use of specialty linens in addition to standard techniques for preventing pressure injuries can help prevent pressure injuries from developing in high-risk patients in intensive care units.
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