317 Patient Engagement through Advanced Pressure Visualization as a Component of Pressure Injury Prevention

Abstract

Hospital acquired pressure ulcers represent one of the most frequent health care problems in clinical practice. Burn patients specifically pose a greater challenge due to loss of skin integrity, post-op positioning requirements and high levels of moisture. As an adjunct to unit based standard of care, a new technology was initiated to identify if pressure visualization will encourage patient engagement in repositioning as a component of pressure injury prevention. The purpose of this project is to evaluate the impact of a new advanced pressure visualization (APV) system on patient engagement through visual feedback where body areas are exposed to pressure. The definition of engagement for this purpose is from Gruman, et al, as “actions individuals must take to obtain the greatest benefit from the health care services available to them.” Patients in the Burn Center with intact cognitive awareness and the ability to see and respond to a color screen at the foot of the bed were included. An APV was installed on all beds, which included a pressure sensor mat inside the mattress connected to a display tablet mounted at the foot of the bed. This tablet displays their body image with continuous pressure readings utilizing a color gradient to exhibit pressure values. Patients were educated on the colors reflective of high- low pressures on their individual body image. The color display indicates specific pressure measurements: ‘red’ is >75mmHg, orange is 60-74mmgHg, yellow is 45-59mmHg, green is 30-44mmHg, light blue is 15-29mmHg and dark blue 1-14mmHg. Patients were asked to reposition themselves, or request repositioning assistance from the health care team, to an area of lesser pressure color when areas of high pressure colors (red, orange or yellow) were noted. Data from the APV device was utilized to determine reduction in peak pressure with patient repositioning. Data from 10 patients and 20 repositions were identified. Initial peak pressures shown by APV images, averaged 73.5 mmHg. The average reduction in peak pressure after the ten patients self-repositions was 41.25 mmHg. The National Pressure Ulcer Advisory Panel prevention and treatment guidelines encourage patients to work with the health care team to develop an individualized pressure ulcer prevention plan. With APV, the patient can easily identify high areas of pressure and actively participate in pressure reduction measures. While patient engagement in this population resulted in reduced pressure, further research related to APV and patient engagement for the prevention of pressure injury is warranted.