An Interdisciplinary Team Approach to Decrease Sacral Hospital-acquired Pressure Injuries: A Retrospective Cohort Study

Abstract

Hospital-acquired pressure injuries (HAPIs) of the sacrum are among the most common iatrogenic events in health care. Multi-intervention programs have been shown to decrease the prevalence of pressure injuries. To assess changes in the yearly incidence of sacral HAPIs before and after implementation of a 3-pronged interdisciplinary intervention to reduce HAPI incidence. A retrospective study of all patients admitted between 2010 and 2017 was conducted to evaluate the effect of a 2012 initiative on the incidence of sacral HAPIs. In 2012, an interdisciplinary team was created, and enhanced education programs for nursing staff and quality data reporting measures were implemented for all patients admitted to North Shore University Hospital, Manhasset, NY. Pre- and post-intervention patient variables and sacral HAPI outcomes were compared. Pre- intervention, the sacral HAPI incidence was 0.353% and 0.267% (mean 0.31%) in the years 2010 and 2011, respectively. Post-intervention the HAPI incidence was 0.033%, 0.043%, 0.008%, 0.007%, and 0.004% in the years 2013, 2014, 2015, 2016, and 2017, respectively (mean 0.019%) (2-sample unpaired t-statistic: 11.5937; P < .001). Significant variables and outcomes differences between pre-intervention (n = 245) and post-intervention (n = 49) patients with a sacral HAPI were seen for race (P < .0001), length of stay (P = .0096), and HAPI stage (P < .0001). A hospital-wide, multi-part, interdisciplinary intervention resulted in a significant and sustained reduction in the incidence of sacral HAPIs.