Reducing Hospital-Acquired Pressure Injuries through Measure-vention

Evidence has shown that Braden subscale scores are independent predictors of the development of pressure injuries. However, current practice is to implement preventive measures for pressure injuries based on the total Braden Scale score. Applying evidence from the literature on Braden subscales and using "Measure-vention," a quality improvement project using Braden subscales, was implemented in a 30-bed ICU in a Northern California level II trauma acute care hospital. The pilot study's purpose was to test whether tailoring interventions specific to the patient's subscale risk would decrease the incidence of hospital-acquired pressure injuries (HAPIs). A 6-month pilot was launched for all patients in the ICU, regardless of Braden total score. Frontline staff collected data in real time, measuring adherence to the "Interventions by Braden Subscale" protocol, and event reports were aggregated to measure the incidence of HAPIs before and after the pilot. At the end of the pilot, the ICU noted a decrease in HAPIs by 63.5%. The results demonstrated the efficacy of using the Braden subscales to guide preventive HAPI care, preventing both HAPIs and the overutilization of resources.