Related Experiment Video
Updated: Jul 15, 2025
An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
Published on: November 30, 2022
Implementation of a Pressure Injury Prevention Protocol for Intensive Care Unit Patients Undergoing Prone Positioning
Kelly McFee1, Julie M Murdoch2, Mandy Spitzer3
1Kelly McFee is Director of Wound Care, Mosaic Wound Care and Hyperbaric Medicine, St. Joseph, Missouri.
Insights
Implementing a new protocol significantly reduced hospital-acquired pressure injuries in COVID-19 patients undergoing prone positioning. This quality improvement initiative lowered injury rates by 76.7%, highlighting the importance of targeted prevention strategies.
Area of Science:
- Healthcare quality improvement
- Infection control
- Patient safety
Background:
- Hospital-acquired pressure injuries are a common healthcare concern, particularly for COVID-19 patients.
- COVID-19 patients face elevated risks due to factors like prolonged intubation and prone positioning.
- A specific hospital identified the need for interventions to mitigate pressure injury risk during the pandemic.
Purpose of the Study:
- To decrease the incidence of hospital-acquired pressure injuries in intensive care unit patients with COVID-19.
- To evaluate the effectiveness of a new protocol for pressure injury prevention in this high-risk population.
Main Methods:
- A quality improvement project was conducted in a 350-bed hospital.
- A protocol involving dressing packets was implemented for COVID-19 patients on prone positioning.
- Pressure injury incidence was compared before and after protocol implementation.
Main Results:
- The incidence of hospital-acquired pressure injuries decreased from 11.6% to 2.7% after protocol implementation.
- This represents a statistically significant reduction of 76.7% (P = .008).
- The study involved 155 patients before and 111 patients after the intervention.
Conclusions:
- Targeted education and specific products/protocols can effectively reduce pressure injury risk.
- A pressure injury prevention protocol, including dressing packets, may benefit all patients requiring prone positioning.
- The findings support the broader application of this protocol beyond COVID-19 patients.
Background:
Pressure injuries remain the most common hospital-acquired condition, according to the Agency for Healthcare Research and Quality. Patients hospitalized with COVID-19 are at especially high risk for pressure injuries, including those related to medical devices, because of their lower tissue tolerance, prolonged intubation, and common treatment with prone positioning.
Local Problem:
The COVID-19 pandemic brought an increased incidence of hospital-acquired pressure injury. A 350-bed hospital in St. Joseph, Missouri, recognized that an intervention to lower the risk of pressure injury for these patients was needed.
Methods:
A quality improvement project was initiated to reduce the incidence of pressure injuries in patients with COVID-19 in the intensive care unit. A protocol was implemented for patients with COVID-19 undergoing prone positioning that included the use of dressing packets. The incidence of hospital-acquired pressure injury during the 1-year periods before and after implementation of the protocol were determined.
Results:
Before implementation of the new protocol, 18 of 155 intensive care unit patients with COVID-19 who were placed in a prone position (11.6%) experienced a hospital-acquired pressure or medical device-related injury, compared with 3 of 111 patients (2.7%) after protocol implementation, a reduction of 76.7% (P = .008).
Conclusions:
The risk of hospital-acquired pressure injuries can be reduced with additional education and the use of appropriate products and protocols. All patients who undergo prone positioning, regardless of diagnosis, may benefit from implementation of a pressure injury prevention protocol that includes the use of dressing packets.
More Related Videos
Related Concept Videos
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:29Decreased Body Temperature
01:26Standard Precaution
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...