Measuring hospital-acquired pressure injuries: A surveillance programme for monitoring performance improvement and estimating annual prevalence

Jull, Andrew; McCall, Elaine; Chappell, M.R.C.S. Walter F.; Tobin, Sam

doi:10.1016/j.ijnurstu.2016.02.005

Cited by 11 publications

(9 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prior studies have shown the most common location of patients developing pressure injuries during hospitalization was in the ICUs 5,6. Aligned with previous research, the majority of injuries were located on the sacrum, followed by the heel and foot, buttock, lip, nares, and occiput 6,10. For the 33.0% of patients with medical device-related pressure injuries, the most commonly implicated device was endotracheal tubing, followed by nasogastric and tracheostomy plates, this finding is similar to previously published literature 31.…”

Section: Discussionsupporting

confidence: 88%

See 1 more Smart Citation

Utilizing a Comprehensive Wound Care Team to Lower Hospital-Acquired Pressure Injuries in an Academic Public Hospital

Powell¹,

Winn²,

Andersen³

et al. 2022

Journal of Wound, Ostomy &Amp; Continence Nursing

View full text Add to dashboard Cite

PURPOSE:Hospital-acquired pressure injuries (HAPIs) have significant impacts on patient morbidity and mortality, with approximately 2.5 million patients treated for pressure-related injuries annually. 1 This study aimed to describe the influence of a comprehensive wound care team on HAPIs over an 8-year period. DESIGN: Retrospective cohort study. SUBJECTS AND SETTING: All inpatients at an academic public hospital system with HAPIs during the study period from May 2012 to February 2020. METHODS: Data on wound stage, location, infection, medical device location if applicable, and risk factors were recorded from medical records. A 1-way analysis of variance was performed to assess for significance of mean number of cases, National Pressure Injury Advisory Panel (NPIAP) stage on initial presentation, and mean number of medical device-related wounds by year. RESULTS: A total of 957 cases were included. The median stage of pressure injury on assessment was 2, with the mean NPIAP stage declining from 2012 to 2020 (P = .003). Thirty-three percent of pressure injuries were attributed to medical devices, most commonly endotracheal tubing. The most common site of pressure injury was the sacrum (33.6%). CONCLUSION: Creation of a comprehensive wound care team within our academic public hospital system demonstrated a significant decline in device-related and pressure injury cases over the past 8 years. The wound care team focused on frequent assessment, education, and evidence-based treatment to lower these HAPI events.

show abstract

Section: Discussionsupporting

confidence: 88%

“…Acquisition of pressure injuries initiates through soft tissue damage most often located near bony prominences 2,10. Focused body weight with a constant pressure of 70 mm Hg or more for more than 2 hours results in cell and tissue ischemia, oftentimes located at the sacrum or heels 5,11,12.…”

Section: Introductionmentioning

confidence: 99%

Utilizing a Comprehensive Wound Care Team to Lower Hospital-Acquired Pressure Injuries in an Academic Public Hospital

Powell¹,

Winn²,

Andersen³

et al. 2022

Journal of Wound, Ostomy &Amp; Continence Nursing

View full text Add to dashboard Cite

show abstract

“…Table summarises the 9 included studies, while Table details the critical appraisal of the included studies using the QI‐MQCS tool. Of the 9 included studies, 3 were not studies of QI processes (1 secondary analysis of pressure ulcer prevalence surveys, 1 a comparison of data presented at unit and facility levels, and the final paper a comparison of the use of regression analysis and SPC), and these 3 publications were not assessed using the QI‐MQCS tool.…”

Section: Resultsmentioning

confidence: 99%

“…The commentaries after the publication of Unbeck et al highlight fundamental challenges such as the selection of the most appropriate control charts, particularly where the denominator at each time point, is liable to differ. Only 1 publication reported how apparent step changes in pressure ulcer incidence over time were identified.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of the use of Statistical Process Control methods to measure the success of pressure ulcer prevention

Clark¹,

Young²,

Fallon³

2018

International Wound Journal

View full text Add to dashboard Cite

Successful prevention of pressure ulcers is the end product of a complex series of care processes including, but not limited to, the assessment of vulnerability to pressure damage; skin assessment and care; nutritional support; repositioning; and the use of beds, mattresses, and cushions to manage mechanical loads on the skin and soft tissues. The purpose of this review was to examine where and how Statistical Process Control (SPC) measures have been used to assess the success of quality improvement initiatives intended to improve pressure ulcer prevention. A search of 7 electronic bibliographic databases was performed on May 17th, 2017, for studies that met the inclusion criteria. SPC methods have been reported in 9 publications since 2010 to interpret changes in the incidence of pressure ulcers over time. While these methods offer rapid interpretation of changes in incidence than is gained from a comparison of 2 arbitrarily selected time points pre- and post-implementation of change, more work is required to ensure that the clinical and scientific communities adopt the most appropriate SPC methods.

show abstract

“…Despite this work, a 2016 policy review reported that New Zealand has no formal reporting requirements for pressure injury (PI), unlike the policies promulgated in similar countries such as Australia and the United Kingdom 1. While the New Zealand Ministry of Health defines PIs as preventable, research published in 2013 indicated that PIs occur across hospital services and age groups 3,4. In 2015, a report estimated the financial cost of a PI was $694 million (NZD) per annum, with 55,000 people in New Zealand sustaining PIs annually 5.…”

Section: Introductionmentioning

confidence: 99%

An Evaluation of Barriers and Facilitators for a Pressure Injury Prevention Link Nurse Role

Moir

Taylor

Seaton

et al. 2022

Journal of Wound, Ostomy &Amp; Continence Nursing

View full text Add to dashboard Cite

PURPOSE: The purpose of this study was to identify barriers and facilitators for nurses in a pressure injury prevention (PIP) link nurse role. DESIGN: Mixed-methods study that used nominal group technique with focus groups, followed by online surveys. SAMPLE AND SETTING: The PIP link nurse project recruited 52 RNs; 32 completed the PIP educational program and participated in data collection. The sample was drawn from PIP link nurses, who were invited to participate in focus groups at the end of the project to identify perceived facilitators and barriers to their role. Focus groups were specific to work areas: aged care and community visiting, and hospital. Two were in an urban setting and one in a rural environment. Twenty-two PIP link nurses participated across 3 groups. To ensure comprehensive data from all involved in the project, online surveys were created using focus group priorities as the basis for questions to send to all PIP link nurses, their managers, and workplace colleagues. METHODS: Participants were invited to participate in focus groups to identify perceived facilitators and barriers to their role. These focus groups were organized around care settings: aged care, community visiting, and hospital. Using a nominal group technique focus group process, participants were asked to identify barriers and facilitators to their role. These were shared with the group until all answers were declared and understood. Voting on order of priority then took place, with majority voting leading to a prioritized list of facilitators and barriers for each group. Considering the similarities and differences across group priorities, researchers developed online surveys representing the main facilitators and barriers from the focus groups. Surveys were then distributed to all PIP link nurses, their managers, and colleagues. Survey data were collected and analyzed in REDCap and reported as percentages of agreement to the questions for each group of respondents. RESULTS: Focus group data indicated facilitating priorities included PIP link nurses' commitment to the role, the support they received from their managers and colleagues, and time release to complete the role. Barriers included lack of time—when other work pressures took priority, and PIP link nurses felt the focus on applying quality improvement theory was more challenging than they had anticipated. Surveys from all groups reiterated the importance of the support of the workplace team in facilitating the role, and the time pressures for the PIP link nurse were a barrier to the role. CONCLUSION: While the funding of such projects is advantageous, it should be carefully and generously considered how much time is required if the project is to succeed so that lack of time to complete the role does not become a barrier to successful completion.

show abstract

Measuring hospital-acquired pressure injuries: A surveillance programme for monitoring performance improvement and estimating annual prevalence

Cited by 11 publications

References 21 publications

Utilizing a Comprehensive Wound Care Team to Lower Hospital-Acquired Pressure Injuries in an Academic Public Hospital

Utilizing a Comprehensive Wound Care Team to Lower Hospital-Acquired Pressure Injuries in an Academic Public Hospital

Systematic review of the use of Statistical Process Control methods to measure the success of pressure ulcer prevention

An Evaluation of Barriers and Facilitators for a Pressure Injury Prevention Link Nurse Role

Contact Info

Product

Resources

About