Can preventative dressings be as effective as specialty beds for HAPI prevention on your unit?

Background: Hospital-acquired pressure injuries (HAPIs) often lead to increased costs, longer hospital lengths of stay, increased recovery time, comorbidities, and death. Despite interventions, HAPIs often manage to develop (Hahnel et al., 2020). Local Problem: In 2022, our medical-surgical unit identified 14 HAPIs (Stage I/II). They began placing patients identified at higher risk for HAPI development (BRADEN score of 17 or less) on treatment surface beds. While the utilization of treatment surface beds reduced HAPIs, it also resulted in higher costs and increased nursing workload. Literature supports the use of preventative foam dressings in a hospitalized at-risk population for HAPI reduction, providing a lower cost alternative to treatment surface beds. Method: Nursing staff placed preventative dressings on the hips, heels, and sacrum of patients with a BRADEN score of 17 or less. The dressings were dated, timed, initialed, and marked with a “P” for preventative. Dressings were changed every seven days, or if loose damp, or soiled. All other evidence based HAPI reduction strategies were continued. Results/Conclusion: In the pre-trial period, zero HAPI events were identified. During the trial period, this rate was maintained. The preventative treatment surface bed cost decreased from $19,343.15 to $750.32. The dressing utilization added a cost of $3242.20, assuming dressings were changed every 7 days. Total cost savings of approximately $15,350.63 were appreciated. Strengths of this trial include leadership support and staff satisfaction. Limitations include patient flow, BRADEN score inconsistencies, manual data abstraction, lack of patient day data, and lack of dressing utilization data. Learning opportunities include a need for patient and family education, and staff education regarding labeling and placement of preventative dressings. Implications for Practice: More data is needed to determine the statistical significance of the results. Next steps will be to spread this process facility-wide to further assess impact on patient outcomes, nursing satisfaction, and cost reduction