Reducing Hospital Acquired Pressure Ulcers

Pressure ulcers have been a persistent issue in hospitals for many years and continue to remain a major cause of morbidity and mortality. Most hospital acquired pressure ulcers (HAPUs) are considered preventable and are identified by the National Quality Forum as a nurse-sensitive quality indicator. Intensive care patients in particular tend to be at a higher risk to develop PUs and prevention in the intensive care population continues to be a major challenge in many hospitals. Recently, some intensive care units have been utilizing a preventative silicone foam barrier dressing applied to patients admitted to the unit in order reduce the incidence of HAPUs. The purpose of this research was to determine if a silicone foam border dressing applied to medical intensive care patients would result in a decreased sacral HAPU occurrence rate in the medical ICU. The data collection took place at the Miriam Hospital, a 247-bed tertiary care hospital in Providence, Rhode Island. The medical ICU at the Miriam Hospital is a 16-bed unit. A retrospective chart review was conducted on 250 medical records that were coded with ICD-9 codes for pressure ulcers. Group One (treatment group) included medical intensive care unit patients who had preventative dressings applied to the sacrum. Group Two (comparison group) included patients who did not have a preventative dressing applied. Results demonstrated that there was a decrease in the occurrence rate of HAPUs after the preventative dressings were initiated. Recommendations and implications for advanced practice nursing are discussed