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Reducing Pressure Injuries in a Pediatric Cardiac Care Unit: A Quality Improvement Project

Chelsea P Kriesberg Lange1, Jeanne Marie Little, Lynn Mohr

  • 1Chelsea P. Kriesberg (Lange), DNP, PNP-AC, CCRN, CPN, Ann and Robert H. Lurie Children's Hospital of Chicago, Illinois and Advocate Children's Hospital, Chicago, Illinois. Jeanne Marie Little, DNP, Department of Women, Children and Family, Rush University College of Nursing, Chicago, Illinois. Lynn Mohr, PhD, Department of Women, Children and Family, Rush University College of Nursing, Chicago, Illinois. Kimberly Kato, MS, Ann and Robert H. Lurie Children's Hospital of Chicago, Illinois.

Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society
|November 6, 2018
PubMed

Insights

A new protocol significantly reduced hospital-acquired pressure injuries (HAPIs) in pediatric cardiac patients. This evidence-based approach lowered HAPI incidence and severity, improving patient outcomes in critical care settings.

Area of Science:

  • Pediatric critical care medicine
  • Quality improvement initiatives
  • Patient safety research

Background:

  • Hospital-acquired pressure injuries (HAPIs) pose a significant risk to vulnerable pediatric patients, particularly those in cardiac care units.
  • Existing prevention strategies may not adequately address the unique needs of neonates and children requiring advanced cardiac support.
  • A standardized, evidence-based approach is crucial for mitigating HAPI development in this high-risk population.

Purpose of the Study:

  • To develop and implement an evidence-based protocol for pressure injury prevention in a pediatric cardiac care unit.
  • To reduce the incidence, prevalence, and severity of hospital-acquired pressure injuries (HAPIs) in neonates and children.
  • To establish a foundation for broader dissemination of the protocol across pediatric critical care settings.

Main Methods:

  • Development of a pressure injury prevention protocol based on National Pressure Ulcer Advisory Panel guidelines.
  • Implementation of the protocol in a pediatric cardiac care unit serving the Midwestern United States.
  • Monitoring of pediatric patients for pressure injury development for six months post-implementation.

Main Results:

  • During the 40-month pre-intervention period, 60 hospital-acquired pressure injuries (HAPIs) were recorded, with 13 being higher than Stage 3.
  • In the 6-month post-intervention period, zero HAPIs greater than Stage 2 were observed.
  • The standardized protocol demonstrated a significant reduction in the incidence, prevalence, and severity of HAPIs.

Conclusions:

  • A standardized, evidence-based pressure injury prevention protocol is effective in reducing HAPIs in pediatric cardiac patients.
  • Protocol implementation led to a marked decrease in severe pressure injuries, enhancing patient safety.
  • The findings support the broader adoption of this protocol in pediatric critical care and acute care settings.

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