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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

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A nurse-led skin team (ST) reduced hospital-acquired pressure injuries (HAPIs) in a cardiothoracic intensive care unit (CTICU). Despite no significant downward trend, HAPI rates remained below national benchmarks, demonstrating sustained improvement.

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Area of Science:

  • Quality Improvement
  • Nursing Interventions
  • Patient Safety

Background:

  • Rising incidence of hospital-acquired pressure injuries (HAPIs) in a cardiothoracic intensive care unit (CTICU).
  • Need for proactive strategies to prevent pressure injuries in critically ill patients.

Purpose of the Study:

  • Evaluate the impact of a nurse-led skin team (ST) on HAPI prevalence (stage 2 and above).
  • Assess the effectiveness of ST interventions in a specialized intensive care setting.

Main Methods:

  • Established a nurse-led ST in 2011 using the Plan-Do-Study-Act framework.
  • Implemented evidence-based and innovative interventions including staff education, rounding, and monitoring.
  • Analyzed patient data from 2011 to 2024 in a Western US CTICU.

Main Results:

  • Trend analysis over a decade did not show a significant decrease in stage 2 and higher HAPI prevalence.
  • However, HAPI rates consistently remained below national benchmarks.
  • The ST approach demonstrated sustained control of HAPI rates.

Conclusions:

  • The nurse-led ST model is effective in maintaining reduced HAPI rates.
  • Ongoing interventions, leadership support, and commitment to quality care are crucial for sustained success.
  • The ST approach provides a valuable framework for pressure injury prevention in intensive care units.