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Sacral Pressure Injury Prevention in Trauma Patients: Silicone-Bordered Multilayered Foam Dressing
Jan Serrano1, Christopher Fernandes Paiva, Fanglong Dong
1Departments of Trauma Services (Dr Serrano), Surgery (Dr Wong), and Emergency Medicine (Dr Neeki), Arrowhead Regional Medical Center, Colton, California; St. George's University, Great River, New York (Mr Paiva); and College of Graduate Medical Science, Western University of Health Sciences, Pomona, California (Dr Dong).
Background:
Hospital-acquired pressure injuries are a chronic phenomenon in health care, and their prevention is an ongoing challenge. This study aims to investigate whether the application of a silicone-bordered multilayered foam dressing during the initial trauma resuscitation reduces sacral hospital-acquired pressure injury occurrence in trauma patients.
Methods:
This is a single-center quality improvement study using a nonequivalent control group posttest-only design to study the effect of silicone-bordered multilayered foam dressing on the incidence of hospital-acquired pressure injuries. The study population included admitted, highest tier trauma activations, age 18 years and older. Preimplementation 2014 data were compared with postimplementation 2018 data.
Results:
The result showed no statistically significant reduction in hospital-acquired pressure injury occurrence between the control and intervention groups. Incident rates for sacral hospital-acquired pressure injuries were 0.23% (2014) compared with 0.21% (2018). No statistically significant difference was found in the hospital and intensive care lengths of stay or injury severity. Preventive dressing costs were $7,689 annually compared with the estimated treatment costs of $70,000 per hospital-acquired pressure injury.
Conclusion:
Although this study's hospital-acquired pressure injury reduction rate was not significant, the inclusion of multidisciplinary team members in the quality improvement project led to the cultural hardwiring of hospital-acquired pressure injury prevention among all team members beyond that of just nursing.
