Pressure Injury Prevention for Complex Cardiovascular Patients in the Operating Room and Intensive Care Unit: A Quality Improvement Project.
Joyce Pittman, Dawn Horvath, Terrie Beeson and 5 others
PMID 34591039WHAT IT FOUND
Adding a dynamic alternating pressure overlay to standard care eliminated operating room-related pressure injuries in high-risk cardiovascular patients.
It did not significantly reduce injuries in the intensive care unit, but it replaced expensive fluid surfaces at lower cost and was well-liked by staff.
Key findings
01Operating room-related pressure injuries dropped from 11% (8/71 patients) before the intervention to zero after adding the alternating pressure overlay.
02In the intensive care unit, pressure injury prevalence decreased slightly but not significantly, and incidence density showed no statistically significant improvement.
03Replacing rented fluid immersion surfaces with the alternating pressure overlay resulted in an estimated 48% cost savings for surface use.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used aggregate unit data rather than following individual patients, which makes it difficult to determine if the same patients were at risk. It was a quality improvement project, not a randomized controlled trial, so other changes in care or patient mix could have influenced the results. The ICU population included many patients who did not meet the criteria for the overlay, which may have diluted the apparent effect on unit-wide pressure injury rates. The study was conducted in a single high-volume academic center, so results may not apply to less complex settings. The project team was composed of nurses who also provided care, which may have introduced bias in implementation or data collection.
Declared interests
The study was supported by a research grant from Dabir Surfaces, the manufacturer of the overlay. One author, Joyce Pittman, is a speaker for Dabir Surfaces.
The easy way to misread this
Do not conclude that the alternating pressure overlay prevents all pressure injuries in the ICU. The reduction in ICU pressure injuries was not statistically significant, and the primary benefit was seen in the operating room setting.