Blending Evidence-Based Practice and Lean Six Sigma Methodology to Reduce Hospital-Acquired Pressure Injuries in a...

Area of Science:

• Healthcare quality improvement
• Patient safety initiatives
• Clinical nursing research

Background:

• Hospital-acquired pressure injuries (HAPIs) present a persistent challenge in acute care settings.
• Standard best practices for HAPI reduction include assessment, documentation, patient positioning, and treatment.
• A specific gastrointestinal/genitourinary progressive care unit experienced higher HAPI rates despite adherence to evidence-based practices.

Purpose of the Study:

• To investigate the high incidence of HAPIs in a specific hospital unit.
• To implement a novel program to reduce HAPI rates effectively.
• To evaluate the impact of a combined methodology on HAPI prevention.

Main Methods:

• A hybrid approach integrating Lean Six Sigma principles with evidence-based practice was employed.
• A targeted intervention, the T program (turn, touch, and tidy), was developed based on root cause analysis.
• The program focused on addressing identified areas of concern contributing to HAPI development.

Main Results:

• The implementation of the T program led to a significant reduction in HAPIs.
• HAPI incidence decreased from 22 cases in the preceding two quarters to zero for three consecutive quarters.
• This reduction resulted in an estimated cost avoidance of $379,767.

Conclusions:

• The successful reduction of HAPIs was attributed to the synergistic effect of the T program.
• Blending Lean Six Sigma methodologies with evidence-based practice proved effective in achieving zero HAPIs.
• The T program serves as a successful model for improving patient safety and reducing healthcare-associated complications.