Decreasing Pressure Injuries From Respiratory Devices in the Pediatric Intensive Care Unit

Problem: Patients developing pressure injuries while admitted to the hospital has become a nationwide problem. The national annual cost of treating pressure injuries is $11 billion dollars, with up to $70,000 dollars for stage four pressure injuries (Cooper et al., 2020). Purpose: The purpose of this project was to implement the use of a silicone foam dressing under respiratory devices, monitored using kamishibai cards (k-cards) to decrease pressure injuries. K-cards are a rounding tool that staff can use to identify barriers that prevent the standard of care. Intervention: A pre-study, three-month period, was compared to the implementation period in the pediatric intensive care unit at a major hospital system in South Carolina. During this time, thirty-eight k-cards were completed on patients needing respiratory devices. Results: The PICU saw a thirty-three percent decrease in the number of pressure injuries in 2022 related to respiratory devices after the rounding tool and foam dressing was implemented compared to 2021. Conclusion: The results of this project confirmed that proactive use of the silicone foam dressing and a rounding tool to educate staff and identify barriers on skin protection can reduce the risk of skin breakdown to our vulnerable patients