Impact of missed interventions on tissue injury outcomes identified via sub-epidermal moisture scanning

Sub-epidermal moisture scanning is an emerging tool for the early detection of hospital-acquired pressure injuries. However, the impact of missed interventions following high SEM readings remains underexplored. This study examined the relationship between intervention compliance, missed interventions, and ΔSEM improvement in patients in an intensive care unit and a rehabilitation unit. Sub-epidermal moisture (SEM) scanning is a validated tool for the early detection of hospital-acquired pressure injuries (HAPIs). However, the impact of missed interventions following high SEM readings remains underexplored. This study examines the relationship between intervention compliance, missed interventions, and ΔSEM improvement in patients from an intensive care unit (ICU) and a rehabilitation unit.

This prospective observational study was conducted in a metropolitan ICU and a secondary rehabilitation unit in Australia. Daily SEM scanning was conducted alongside standard HAPI prevention measures. A ΔSEM value ≥ 0.6 triggered clinical interventions. Missed interventions were defined as the absence of additional care following a high ΔSEM reading. Descriptive and inferential statistics were used to explore associations between compliance and ΔSEM improvement.

Among 229 patients, including 181 in the rehabilitation unit and 48 in the ICU, high ΔSEM values were observed in 75.5 % and 79.2 % of patients, respectively. SEM-guided interventions were associated with a 63 % reduction in HAPI incidence in the rehabilitation unit and improved ΔSEM outcomes in ICU patients. Three missed interventions resulted in persistent high ΔSEM values in ICU and four in the rehabilitation cohort indicating a potential critical window.

Timely interventions following high SEM readings are critical for improving tissue health and reducing HAPI risk. Further research should explore critical windows for responsive care in different patient cohorts. Scanning protocols and interventions should be tailored to specific clinical environments.