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An Interdisciplinary Team Approach to Decrease Sacral Hospital-acquired Pressure Injuries: A Retrospective Cohort
Shelby Isaacs1, Tamir Pinhasov1, Alisha Oropallo2
1Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.
Insights
Hospital-acquired pressure injuries (HAPIs) are common. A multi-faceted intervention significantly reduced sacral HAPIs, demonstrating the effectiveness of interdisciplinary care in preventing these adverse events.
Area of Science:
- Healthcare Quality Improvement
- Patient Safety
- Nursing Research
Background:
- Hospital-acquired pressure injuries (HAPIs) of the sacrum are a significant iatrogenic complication in healthcare settings.
- Multi-intervention strategies have demonstrated efficacy in reducing the prevalence of pressure injuries.
Purpose of the Study:
- To evaluate the impact of a comprehensive, interdisciplinary intervention on the annual incidence of sacral HAPIs.
- To compare sacral HAPI rates before and after the implementation of a quality improvement initiative.
Main Methods:
- A retrospective analysis of patient data from 2010 to 2017 at North Shore University Hospital.
- Implementation of a 3-pronged intervention in 2012: interdisciplinary team, enhanced nursing education, and quality data reporting.
- Comparison of sacral HAPI incidence and patient variables pre- and post-intervention.
Main Results:
- Pre-intervention sacral HAPI incidence averaged 0.31% (2010-2011).
- Post-intervention sacral HAPI incidence significantly decreased to an average of 0.019% (2013-2017) (P < .001).
- Significant differences observed in race, length of stay, and HAPI stage between pre- and post-intervention groups.
Conclusions:
- A hospital-wide, multi-component, interdisciplinary intervention effectively reduced sacral HAPI incidence.
- The intervention led to a sustained and statistically significant decrease in hospital-acquired pressure injuries.
- This study highlights the importance of integrated care approaches in enhancing patient safety and preventing HAPIs.
Background:
Hospital-acquired pressure injuries (HAPIs) of the sacrum are among the most common iatrogenic events in health care. Multi-intervention programs have been shown to decrease the prevalence of pressure injuries.
Purpose:
To assess changes in the yearly incidence of sacral HAPIs before and after implementation of a 3-pronged interdisciplinary intervention to reduce HAPI incidence.
Methods:
A retrospective study of all patients admitted between 2010 and 2017 was conducted to evaluate the effect of a 2012 initiative on the incidence of sacral HAPIs. In 2012, an interdisciplinary team was created, and enhanced education programs for nursing staff and quality data reporting measures were implemented for all patients admitted to North Shore University Hospital, Manhasset, NY. Pre- and post-intervention patient variables and sacral HAPI outcomes were compared.
Results:
Pre- intervention, the sacral HAPI incidence was 0.353% and 0.267% (mean 0.31%) in the years 2010 and 2011, respectively. Post-intervention the HAPI incidence was 0.033%, 0.043%, 0.008%, 0.007%, and 0.004% in the years 2013, 2014, 2015, 2016, and 2017, respectively (mean 0.019%) (2-sample unpaired t-statistic: 11.5937; P < .001). Significant variables and outcomes differences between pre-intervention (n = 245) and post-intervention (n = 49) patients with a sacral HAPI were seen for race (P < .0001), length of stay (P = .0096), and HAPI stage (P < .0001).
Conclusion:
A hospital-wide, multi-part, interdisciplinary intervention resulted in a significant and sustained reduction in the incidence of sacral HAPIs.
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