Pressure injury prevention in adult critically ill patients: best practice implementation project.

Abstract

This study assessed compliance with the best practices for pressure injury prevention among ICU patients at a tertiary hospital in São Paulo, Brazil. Intensive care patients are at a high risk of developing a pressure injury; preventing this requires a best practice protocol. This best practice implementation project was developed in a Brazilian tertiary hospital in three phases following the method proposed by the Joanna Briggs Institute. Ten criteria established based on the best available evidence were audited and monitored before and after best practice implementation. The baseline and follow-up audits evaluated 28 patients at each step. A total of 448 h of care were analyzed using a monitoring camera and medical records. Compliance with all 10 audited criteria increased, with a 50% reduction in the prevalence of pressure injuries in intensive care. Of the 223 employees, 71% claimed to have some knowledge of pressure injury prevention, and 66% reported adequate adherence to prevention protocols. The audit and feedback strategy improved compliance with the criteria. Future audits are needed to promote the sustainability of evidence-based practice.