Outcomes of a Quality Improvement Program to Reduce Hospital-acquired Pressure Ulcers in Pediatric Patients

Area of Science:

• Pediatric Healthcare Quality Improvement
• Patient Safety Research
• Hospital-Acquired Conditions

Background:

• Hospital-acquired pressure injuries (PIs) pose a significant challenge in pediatric care settings.
• A comprehensive prevention strategy is crucial to mitigate the incidence and severity of pediatric pressure ulcers (PUs)/PIs.

Purpose of the Study:

• To develop and implement a debrief protocol for pediatric pressure ulcers (PUs)/PIs.
• To evaluate compliance with a comprehensive prevention bundle aimed at reducing PU/PI incidence and severity.
• To decrease the overall incidence and severity of pediatric pressure ulcers (PUs)/PIs in a children's hospital.

Main Methods:

• A quality improvement program was initiated within a national patient safety network.
• A PU Hospital Acquired Conditions (HAC) team developed a debrief tool, discussion guide, educational strategies, and a prevention bundle.
• PU incidence data were collected annually from 2014 to 2017, with debriefings occurring within 24-48 hours of PU occurrence.

Main Results:

• Compliance with the prevention bundle elements ranged from 88% to 94%.
• The incidence of PUs/PIs decreased by 30% from 2014 to 2016 and by 40% in 2017.
• Device-related PIs constituted 65% of cases, with respiratory devices being the most common cause; significant reductions were observed in respiratory device-related PIs across various units.

Conclusions:

• The integrated approach of debriefing, education, and a prevention bundle effectively reduced hospital-acquired PIs in pediatric patients.
• The program successfully propagated a culture of safety within the pediatric healthcare setting.
• The findings highlight the importance of targeted interventions for device-related PIs in vulnerable pediatric populations.