Impact of a Pressure Injury Prevention Bundle in the Solutions for Patient Safety Network

Area of Science:

• Pediatric Healthcare
• Patient Safety
• Quality Improvement

Background:

• Pediatric hospitals face challenges in reducing pressure injury (PI) rates.
• Implementing standardized prevention strategies is crucial for patient safety.

Purpose of the Study:

• To evaluate the impact of an active surveillance and prevention bundle on pressure injury rates in pediatric hospitals.
• To assess the association between the implementation of bundle elements and pressure injury reduction.

Main Methods:

• Utilized negative binomial analyses to assess changes in PI rates in hospitals participating since 2011.
• Employed funnel charts to examine the relationship between bundle implementation compliance and PI rates among all participating hospitals.
• The Children's Hospitals Solutions for Patient Safety (SPS) Network implemented a three-pronged approach: active surveillance, bundle compliance measurement, and wound ostomy team deployment.

Main Results:

• A significant decline in stage 3 pressure injuries (0.06 to 0.03 per 1,000 patient-days) and stage 4 pressure injuries (0.01 to 0.004 per 1,000 patient-days) was observed in phase 1 hospitals.
• Hospitals achieving 80% prevention bundle compliance demonstrated significantly lower PI rates compared to the overall cohort.
• The study included 33 hospitals in phase 1 (2011-2013) and 78 hospitals across phases 1 and 2 (2013).

Conclusions:

• The implementation of the prevention bundle by SPS hospitals led to a significant reduction in stage 3 and 4 pressure injuries over two years.
• Consistent and reliable implementation of each component of the prevention bundle is associated with decreased pressure injury rates.