Decreasing Hospital-acquired Pressure Injuries During the COVID-19 Pandemic: A 5-step Quality Improvement Approach.

Area of Science:

• Healthcare quality improvement
• Patient safety research
• Infection control

Background:

• Hospital-acquired pressure injuries (HAPIs) present a significant burden to patients and healthcare systems.
• HAPI incidence increased during the COVID-19 pandemic, rising from 2.92% to 3.80% in the study health system.
• A 50% reduction in HAPIs stage II and above was targeted over three years.

Purpose of the Study:

• To implement and evaluate a multidisciplinary quality improvement program to reduce HAPIs.
• To address the rise in HAPI rates observed during the COVID-19 pandemic.
• To enhance patient safety and reduce adverse events in a hospital setting.

Main Methods:

• A comprehensive quality improvement program was designed.
• Key components included governance, education, practice changes, data monitoring, and environmental modernization.
• The program was implemented across a health system during the COVID-19 pandemic.

Main Results:

• HAPI rates decreased by 58%, from 3.8% to 1.6% (P <0.00001).
• Use of the Braden Risk Assessment Tool improved from 88.2% to 92.2% (P =0.00024).
• Patient falls with injuries decreased from 1.5 to 1.0 per 1000 patient days (P =0.0009).

Conclusions:

• A multidisciplinary quality improvement program effectively reduced HAPI rates by approximately 58%.
• The program demonstrated success even amidst pandemic-related resource constraints and heightened infection control measures.
• Evidence-based practices and real-time data access were crucial for the program's success in improving patient outcomes.