Abstract P-463: MEDICAL DEVICE-RELATED PRESSURE ULCER PREVENTION BUNDLE IN A PAEDIATRIC UNIT: EVIDENCE-BASED QUALITY IMPROVEMENT PROJECT

Abstract

Aims & Objectives: Medical device-related pressure ulcer (MDRPU) is one of the most preventable injuries worldwide yet becoming increasingly prevalent. This evidence-based quality improvement (EBQI) project aims to achieve 50% reduction in reported MDRPU within a paediatric intensive care unit (PICU) in a Singapore tertiary hospital. Methods An EBQI project utilising pre and post-implementation of MDRPU prevention bundle audit strategy. PICU patients were selected by consecutive sampling if they used oro-nasal or nasal non-invasive ventilation mask for minimum 24 hours continuously. Education sessions on the MDRPU prevention bundle were conducted by the PICU evidence-based nursing (EBN) champions from January to August 2017 (Figure 1). Visual aids (Figure 2) were placed in strategic locations in PICU. Thin foam dressings were used for patients under 5 years old and thicker foam dressing above 5 years old. Incidences of reported MDRPU were compared between 2016 and 2017. Clinical observation audit data on the nurses’ application technique, material selection and documentation of skin assessment and interventions were collected.Results Incidences of reported MDRPU decreased from 5% in 2016 to 1.96% in 2017, showing a relative risk reduction of 60.7%. Clinical observation audit data collection is ongoing and expected to be completed by March 2018. To date, nurses have selected appropriate materials and displayed proper application technique. Conclusions The MDRPU bundle was effective in reducing incidences of reported MDRPU by more than 50%. The project was successful as the PICU EBN champions introduced the MDRPU bundle, conducted education sessions and managed to close the gaps of nurses’ knowledge and practices related to MDRPU.