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Reducing Pressure Injuries in the Pediatric Intensive Care Unit

Kristin A Cummins1, Richard Watters2, Treasa 'Susie' Leming-Lee3

  • 1Quality and Safety Department, Riley Hospital for Children at Indiana University Health, 705 Riley Hospital Drive, Suite RI 2962, Indianapolis, IN 46202, USA.

The Nursing Clinics of North America
|February 5, 2019
PubMed

Insights

This quality improvement project reduced pediatric pressure injury incidence in the pediatric intensive care unit (PICU) by educating nurses and implementing new protocols. The initiative successfully decreased the pressure injury rate from 8% to 3%.

Area of Science:

  • Pediatric critical care nursing
  • Quality improvement in healthcare
  • Patient safety initiatives

Background:

  • Pediatric pressure injuries (PPIs) represent a significant source of preventable patient harm in pediatric intensive care units (PICUs).
  • Effective prevention strategies require comprehensive nursing education and robust implementation protocols.
  • Early nutritional intervention is crucial for tissue integrity and healing in critically ill children.

Purpose of the Study:

  • To implement a quality improvement project aimed at reducing the incidence of pressure injuries in a PICU.
  • To enhance nursing knowledge regarding PPI risk factors and evidence-based prevention strategies.
  • To improve patient outcomes through targeted interventions, including enhanced turning compliance and timely nutrition consultations.

Main Methods:

  • Utilized the Model for Improvement framework, incorporating the Plan-Do-Study-Act (PDSA) cycle for iterative changes.
  • Delivered targeted education to PICU nurses on pediatric pressure injury risks and prevention.
  • Implemented a standardized turning schedule and an electronic trigger for nutrition consultations based on Braden Q scores (<16).

Main Results:

  • The incidence rate of preventable pressure injuries in the PICU decreased significantly from 8% to 3% over a 6-week period.
  • Improved adherence to patient turning protocols was observed.
  • Successful implementation of electronic triggers facilitated timely nutrition consults for high-risk patients.

Conclusions:

  • The quality improvement project effectively reduced pressure injury incidence in the PICU.
  • Multifaceted interventions, including education, protocol adherence, and technology integration, are key to preventing patient harm.
  • Sustained focus on evidence-based practices is essential for maintaining patient safety in critical care settings.

Keywords:
PediatricsPressure injuriesPressure ulcersSkin integrityWounds

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