Reducing the Incidence of Pressure Injuries in Adult ICU Patients at McAllen Medical Center with the Implementation of a Pressure Injury Preventive Bundle: A Quality Improvement Project

Abstract

Practice Problem: Pressure injuries (PIs) are a significant healthcare problem globally. Adult patients in the intensive care setting are especially vulnerable to the development of PIs given the acuity of their diagnoses requiring extensive treatments, procedures and the use of multiple medical devices. PICOT: The PICOT question that guided this project was, “In adult intensive care unit (ICU) patients, how does the effect of implementing a pressure injury prevention bundle compare in patients who received the bundle, and patients receiving standard pressure injury prevention in reducing the incidence of pressure injuries after two months?” Evidence: Evidence exist that bundle implementation significantly reduced incidence of PIs in adult ICU patients. Intervention: A pressure injury preventive bundle consisting of six evidence-based interventions were consistently and collectively implemented to reduce incidence of PIs in adult ICU patients at a tertiary hospital in South Texas. Further, a multidisciplinary approach, monitoring, auditing, and providing constructive feedback to staff were employed to ensure appropriate implementation and increase likelihood of achieving positive outcomes. Outcome: Findings revealed a 7.37% reduction in incidence after two months of bundle implementation. Also, findings showed more than 90% compliance with five out of the six components of the bundle. Conclusion: The reduction in the incidence of PIs with the implementation of a pressure injury preventive bundle in adult ICU patients was not statistically significant. However, the reduction indicated a clinically meaningful improvement in pressure injury outcomes two months after implementing the bundle.