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A Skin Team Approach to Decrease Pressure Injuries in a Cardiothoracic Intensive Care Unit: A Quality Improvement
Aysa Arenas1,2,3,4,5,6,7, Stephanie Sheldrick1,2,3,4,5,6,7, Sarah Sutton1,2,3,4,5,6,7
1Aysa Arenas, MSN, RN, Cardiothoracic Intensive Care Unit, Ronald Reagan UCLA Medical Center, Los Angeles, California.
Purpose:
The primary purpose of this quality improvement initiative was to evaluate the effect of a nurse-led skin team (ST) interventions on prevalence of hospital-acquired pressure injuries (HAPIs) of stage 2 and above in our cardiothoracic intensive care unit (CTICU).
Participants And Setting:
Data analysis is based on patients receiving care in our CTICU from 2011 to 2024. The unit is located in the Western US (Los Angeles, CA).
Approach:
A nurse-led ST was established in 2011 to empower and engage clinical nurses in addressing the rising incidence of HAPIs in the CTICU. The team employed the Plan-Do-Study-Act framework to implement both evidence-based and innovative interventions. Project strategies included rounding, monitoring, and educating staff on best practices for pressure injury prevention.
Outcomes:
More than a decade after the team's formation, trend analysis did not demonstrate a significant downward trend in stage 2 and higher HAP prevalence. Nevertheless, our HPAI rates have consistently been below national benchmarks.
Implications For Practice:
The ST approach has proved effective in sustaining a reduction of HAPIs within our facility. The team's interventions remain ongoing, supported by facility leadership and continued commitment to quality care.
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