Pressure Injury Prevention Research Articles

The risk and prevalence of pressure injuries in older people in the home care service: a cross-sectional study.

This study aimed to understand the risk of developing pressure injuries (PIs) and their prevalence rate in older adults in Italy who received public funded home care services and who were often living alone. In May 2019, a cross-sectional study was performed according to the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines. The data collection included demographic variables, a PI risk assessment using the Braden Scale score, the type of mobility devices available, the wound description detailing the PI category, body location and ongoing treatment. Data analysis was conducted using non-parametric descriptive statistics. Of the 2223 patients who participated in the study, the risk of developing a PI as measured with the Braden Scale sore was: 'absent' for 37.7%; 'mild' for 25.8%; 'moderate' for 13.8%; 'high' for 15.5%; and 'severe' for 7.1% of patients. The PI prevalence in the sample of home care service patients was 26%, of which 46% were inpatients with a Braden Scale score of <14. Of the PIs that developed during the study, 65% of these developed in patients in home care and of these, 81% had a Braden Scale score of ≤9. PIs developed not only during hospitalisation but at home. Assessing the commitment of patients and caregivers to PI prevention and treatment strategies in home care services could be key to reducing PI prevalence, hospital admissions for PIs, related complications for older people living at home, and the severity of the PI category.

Knowledge and Practice Regarding Pressure Injury Prevention among Nurses at King Abdul-Aziz Specialist Hospital

Context: Preventing hospital-acquired pressure injuries (HAPI) poses a significant challenge within tertiary service hospitals. These skin lesions cause discomfort and elevate the risk of severe infections, leading to increased healthcare costs and a high mortality rate due to sepsis. Thus, prevention requires an interdisciplinary approach to care.&#x0D; Aim: To determine knowledge and practice regarding pressure injury prevention among nurses at King Abdulaziz Specialist Hospital (KAASH). &#x0D; Methods: A cross-sectional descriptive research design was utilized in the current study. One hundred fifty-two staff nurses who work in inpatient units at KAASH were recruited. The researchers developed the knowledge assessment questionnaire and self-reported practice scale. They were used to assess the nursing staff's knowledge and self-reported practice regarding pressure injury prevention and barriers affecting it.&#x0D; Results: Out of the 152 participants, most were women (93.4%) and held a bachelor's degree (88.8%). The mean score for nurses' knowledge concerning preventing pressure injuries (PI) was 6.82±1.89 out of 10. Similarly, the mean score for nurses implementing PI prevention practices was 23.48± 2.81 out of 27. A statistically significant relationship was observed between participants' knowledge of PI prevention and their education, experience, source of PI education, and the most recent PI training attended (p&lt;0.05). Additionally, a statistically significant association was found between participants' implementation of PI prevention practices and their experience level (p&lt;0.05). Furthermore, a significant positive correlation was identified between participants' knowledge and their practices regarding PI prevention (p&lt;0.05). The reported barriers to effective PI prevention included a shortage of staff (lack of aids) reported by 85.52% of participants, and inadequate facilities and equipment mentioned by 69.07%.&#x0D; Conclusion: The results suggest that most nurses possessed a moderate level of knowledge regarding preventing pressure injuries (PI), whereas a significant portion, more than two-thirds of the participants, demonstrated a high degree of commitment to effective PI prevention practices. Developing continuous PI prevention and management training and overcoming barriers to optimal PI prevention practices can be helpful. Finally, monitoring and follow-up are important to ensure the nurses' compliance.&#x0D;

Post training pressure injury knowledge and prevention practice among primary home caregivers of patients discharged from a Level 5 Hospital in Kenya

Post training pressure injury knowledge and prevention practice among primary home caregivers of patients discharged from a Level 5 Hospital in Kenya

A novel approach for quantitative imaging of the seated anatomy of the buttocks using ultrasound and MRI

Background: Pressure injuries are commonly noted in individuals who use wheelchairs for mobility and sit for prolonged periods. Understanding soft tissue composition is an essential part of treating and preventing pressure injuries. This study proposes novel approaches for imaging the soft tissue of the buttocks in unloaded and loaded conditions using ultrasound (US) and magnetic resonance imaging (MRI).Methods: The soft tissue of the buttocks was measured in able-bodied participants (n = 26, 50% female) and one male with a spinal cord injury using an innovative chair that allowed seated US acquisition of the buttocks and a newly developed MRI compatible loader. The US test–retest reliability (reproducibility) of buttocks soft tissue was assessed, and US was validated with MRI. Soft tissue was measured between the peak of the ischial tuberosity (IT) and proximal femur and the skin. MRI was used to quantify the fat fraction of the gluteus maximus muscle, with the goal of determining the influence of intramuscular fat on loaded soft tissue responses and was used to assess tissue thickness during buttocks loading.Results: US reproducibility was excellent, ICC = 0.934–0.981, with no statistical differences between scan days. Coefficients of variation (CVs) between visits ranged from 2.5% to 7.4% for loaded and unloaded tissue. US and MRI measures of tissue thickness were significantly correlated (r = 0.68–0.91, p ≤ 0.001). US underestimated the unloaded tissue thicknesses, with a mean bias of 0.39–0.56 cm. When the buttocks were loaded, US- and MRI-measured total tissue thickness was reduced by up to 64.2% ± 9.1% (p &amp;lt; 0.001). The US- and MRI-unloaded total soft tissue of the IT was correlated with loaded tissue thickness (r = 0.54–0.67, p ≤ 0.027). Intramuscular fat of the gluteus maximus was not correlated to changes in muscle thickness with loading (r = 0.05, p &amp;gt; 0.05).Conclusion: We have developed and validated a novel US methodology using MRI as a comparison measure to investigate soft tissue anatomy and deformation during sitting and loading. The ability to obtain such data in the loaded condition is unique and fills an unmet need in understanding loading and pressure injury formation.

Design of Innovative Clothing for Pressure Injury Prevention: End-User Evaluation in a Mixed-Methods Study.

The global relevance of pressure injury (PI) prevention technologies arise from their impact on the quality of life of people with limited mobility and the costs associated with treating these preventable injuries. The purpose of this mixed methods study is to evaluate the design of a prototype integrating Smart Health Textiles for PI prevention based on feedback from specialist nurses who care for individuals who are prone to or have PIs. This is a mixed methods study. A structured questionnaire was conducted as part of an evaluation of a prototype garment for the prevention of PIs. This questionnaire was applied during the evaluation of the prototype and afterwards focus group discussions were held with experts. Descriptive statistics techniques were used to analyze the data and thematic and integrated content analysis was conducted through concomitant triangulation. Nineteen nurses took part, aged 30 to 39 years (52.6%) and with 12.31 ± 8.96 years of experience. Participants showed that the prototype required more manipulation and physical effort, which interfered its usefulness, in addition to presenting difficulties with the openings and the material of the closure system, which interfered with the ease of use and learning. Overall satisfaction with the product was moderate, with some areas for improvement found, such as satisfaction, recommendations to colleagues, and pleasantness of use. It is concluded that areas for improvement have been found in all dimensions, including in the design of openings and the choice of materials. These findings supply significant insights for improving clothing to meet the needs of healthcare professionals and patients.

Prevention of pressure injuries using a non-motorised decompression air mattress: a non-interventional study.

Prevention of pressure injuries (PI) is a public health issue. Among the preventive measures, the use of support surfaces adapted to the risk of PI occurrence is recommended. This study aimed to report the incidence of PIs in patients at medium-to-high risk of occurrence of PIs and using a new non-motorised automated decompression air mattress combined with other recommended PI prevention measures. An observational, national, multicentre, prospective, non-comparative study, with a follow-up period of 35 days was conducted. Patients at medium-to-high risk of PIs and without PIs at baseline were included if they were lying on a specific non-powered automated decompression air mattress. The primary outcome was the percentage of patients who developed at least one category 2 or more severe PI of the sacrum, backbone or heel between day 0 and day 35. In total, 81 patients were included from four participating centres. There was one report of a patient with a PI that fitted within the definition of the primary outcome, meaning an incidence of 1.2% (95% confidence interval (CI) 0-6.7%). More than 80% of patients rated the overall comfort and the stability of the non-motorised automated decompression air mattress as satisfactory or very satisfactory. In more than 80% of cases, the healthcare teams found the use of the mattress to be easy or very easy. This study has shown that in combination with other preventive measures, the use of a specific non-motorised air mattress with automated decompression is associated with a low incidence of PIs in patients with medium-to-high risk of occurrence of PIs.

Facilitators and barriers to pressure injury prevention, management and education: Perspectives from healthcare professionals-A qualitative study.

This study aims to (1) characterize healthcare professionals' (HCPs') experiences related to the prevention and management of pressure injuries (PIs) and (2) explore the educational needs of individuals with a past or current history of PIs and their caregivers from the perspective of HCPs. This is a qualitative descriptive study. HCPs (n = 18) were interviewed using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and coded using NVivo. Three overarching themes encompassing various dimensions were identified: (1) Facilitators related to PI prevention and management, (2) Challenges related to PI prevention and management and (3) Recommendations for improving patient and caregiver PI education. HCPs identified a greater number of challenges than facilitators related to PI care. This study emphasizes the importance of a patient-centred and interprofessional approach to patient education for PI prevention and management. Meaningful interventions focused on the patient may improve health literacy and empower patients and caregivers in PI care. Investing in preventive measures and raising awareness are crucial to reducing PI incidence. The findings have implications for HCPs and researchers seeking to enhance patient care and promote effective PI prevention strategies.

Workshop (Clinical/Best Practice Implementation) ID 2001167

Background Hamilton’s Spinal Cord Injury (SCI) Regional Rehabilitation Program in collaboration with SCI Consortium is implementing tissue integrity monitoring for pressure injury (PI) prevention. An increased prevalence of PI was found in 2021 - 2022 compared to 2020 on Hamilton’s SCI Rehabilitation Unit. To address this finding, the clinical team introduced a staff and patient education program focused on PI prevention. Upon completion of this workshop, the attendees will be aware of the CQI methodology used to implement the best practices related to tissue integrity and appreciate the education pathway for both staff and patients. Methods Using a Continuous Quality Improvement model, a systematic approach was used to enhance the education model for staff and patients on skin assessment and appropriate interventions. A process map was created outlining steps for each discipline involved in skin assessment, intervention, and patient education. Education plan included Skin &amp; Wound Management workshop, individual and group patient education, daily skin check calendar for patient/staff use. The workshop will be delivered in a lecture format, ending with discussion time. Results Preliminary data post partial implementation of the education program showed a decrease of 12% in the prevalence of PIs in the patients discharged from the program between July 2022 and March 2023 compared to January 2021 – June 2022. Conclusion Preliminary results are encouraging in demonstrating that implementation of a comprehensive education plan for staff and patients using a structured framework is effective in reducing the prevalence of pressure injuries in the inpatient SCI rehab unit.

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

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.

Repositioning for pressure injury prevention in adults: a commentary on a Cochrane review.

Repositioning is regarded as an important intervention to prevent the development of pressure injuries in patients who are immobile. However, there is uncertainty as to the optimal regimen in terms of frequency and method of repositioning. This commentary summarises and critically appraises a Cochrane systematic review that assessed the clinical and costeffectiveness of different repositioning regimens on the prevention of pressure injuries in adults in any setting.

Evaluation of Nurses’ Knowledge and Attitudes to Prevent Pressure Injuries

Amaç: Bu araştırmada hemşirelerin basınç yaralanmalarını önlemeye yönelik bilgi düzeyi ve tutumlarının değerlendirilmesi amaçlanmıştır.&#x0D; Gereç ve Yöntem: Tanımlayıcı ve kesitsel tipteki bu araştırma 01.04.2020-01.09.2020 tarih aralığında bir hastanede çalışan toplam 140 hemşire ile yürütülmüştür. Veriler, "Hemşire Bilgi Formu", ''Basınç Ülseri Önlemede Bilgi Değerlendirme Ölçeği Türkçe versiyonu'' (BÜÖBDÖ) ve "Basınç Ülserlerini Önlemeye Yönelik Tutum Ölçeği (BÜÖYTÖ)" ile toplanmıştır. &#x0D; Bulgular: Katılımcıların yaş ortalaması 26.71±5.55 olup mesleki çalışma süresi ise 6.48±5.09 olarak saptanmıştır. Hemşirelerin, BÜÖBDÖ toplam puanı 26 üzerinden 10.82 puan aldıkları ve sadece %8.5'inin (n=12) doğru cevap yüzdesi ve kabul edilebilir bilgi puanına (≥%60; ≥16) sahip olduğu bulunmuştur. Hemşirelerin BÜÖYTÖ toplam tutum puanı 52 üzerinden 37.10 olarak saptanırken, tutum yüzdesinin %41.6 olduğu belirlenmiştir. Hemşirelerin %42.8'inin (n=60) ortalama tutum puanının ≥%75 (tatmin edici tutum düzeyi) olduğu bulunmuştur. Hemşirelerin yaşları ile tutum puanları arasında pozitif yönde (rs= 0.198; p= 0.019), klinikte çalışma süreleri ile tutum puanları arasında ise negatif yönde zayıf düzeyde bir ilişki olduğu bulunuştur (rs= -0.199; p= 0.018).&#x0D; Sonuç: Hemşirelerin basınç yaralanmalarını önlemeye yönelik bilgileri kabul edilebilir puan düzeyinde ve tutumlarının ise tatmin edici düzeyde olmadığı belirlenmiştir. Basınç yaralanmalarını önlemeye yönelik uygulamaları iyileştirmek için hemşirelerin bilgilerini arttırmaya ve olumlu tutumlar geliştirmelerine yönelik eğitimsel stratejiler ve müdahaleler geliştirilmelidir.

INTERVENTIONS IN THE FACE OF PRESSURE INJURY PREVENTION IN PATIENTS HOSPITALIZED IN INTENSIVE CARE UNITS (ICU)

Identify and understand nursing interventions in the face of pressure injury prevention in patients hospitalized in Intensive Care Units (ICU). Identifying extrinsic/intrinsic factors, scientific knowledge about risk factors, classification, diagnosis and nursing care in the face of pressure injury prevention in patients hospitalized in the Intensive Care Unit (ICU). Identify the nursing interventions in the face of pressure injury prevention in hospitalized patients. Descriptive study of the integrative review type of the literature. Research source: LILACS, BENF, MEDLINE. After applying the inclusion and exclusion criteria, the study sample consisted of 18 articles, filtered between the years of 2017 to 2022, where these studies address the intervention of nursing in the prevention of pressure injury in patients hospitalized in the Intensive Care Unit (ICU). This article showed that nursing interventions are of fundamental importance, and it should be emphasized the constant need to seek technical-scientific knowledge about pressure injury and consequent preparation and execution of treatment plan in order to contribute to the prevention of the emergence of LPP in hospitalized patients in ICU, thus promoting shorter hospital stay and better quality of life in the face of reduced complications resulting from the emergence of a LPP.

A Novel Elastic Sensor Sheet for Pressure Injury Monitoring: Design, Integration, and Performance Analysis

This study presents the SENSOMATT sensor sheet, a novel, non-invasive pressure monitoring technology intended for placement beneath a mattress. The development and design process of the sheet, which includes a novel sensor arrangement, material selection, and incorporation of an elastic rubber sheet, is investigated in depth. Highlighted features include the ability to adjust to varied mattress sizes and the incorporation of AI technology for pressure mapping. A comparison with conventional piezoelectric contact sensor sheets demonstrates the better accuracy of the SENSOMATT sensor for monitoring pressures beneath a mattress. The report highlights the sensor network’s cost-effectiveness, durability, and enhanced data measurement, alongside the problems experienced in its design. Evaluations of performance under diverse settings contribute to a full understanding of its potential pressure injury prediction and patient care applications. Proposed future paths for the SENSOMATT sensor sheet include clinical validation, more cost and performance improvement, wireless connection possibilities, and improved long-term monitoring data analysis. The study concludes that the SENSOMATT sensor sheet has the potential to transform pressure injury prevention techniques in healthcare.

(Invited) soft, Wireless Pressure-Sensor-Integrated Smart Bandage for the Management of Wound Healing

Soft, flexible electronics are promising for many applications including health monitoring, soft robotics, and other intelligent systems. In this talk, I will discuss our recent efforts in developing flexible electronic devices with previously inaccessible capabilities. I will start with our work on soft, wireless pressure-sensor-integrated smart bandage for the management of diabetic foot ulcers. Diabetic foot ulcers (DFUs) have affected millions of people in the U.S. and posed heavy burdens to patients and the healthcare system due to their being slow to heal, high recurrence rate, and potential risk of amputation and even premature death. A mainstay of DFU therapy is mechanical offloading to mitigate pressure at the ulcer, which, however, is usually not effective due to patients’ diminished sensation capabilities on the foot and low adherence to offloading recommendations. I will present our recent effort in developing a soft, flexible, wireless pressure-sensor-integrated smart bandage system for continuously monitoring the pressure on the foot and alerting the users to offload under exceeded pressure. The pressure sensor exhibits high linearity, negligible hysteresis, fast response time, and excellent water-proof properties relevant for this application. Wireless data transmission onto a smartphone via Bluetooth enables the display and interpretation of the measured pressure with the option of a preset pressure threshold, when exceeded, an alert will be generated for immediate notifications. Trials on healthy subjects demonstrate reliable monitoring performance and effectiveness in aiding offloading. The developed smart bandage system represents a significant advance in the prevention and management of DFUs and other pressure injuries as well as compression therapy corrections.

Design and application of the continuous positive airway pressure mask capable of preventing pressure injuries

Design and application of the continuous positive airway pressure mask capable of preventing pressure injuries

Critical care nurses’ knowledge and attitudes toward pressure injury prevention: A pre and post intervention study

ObjectiveTo explore nurses’ knowledge and attitudes towards pressure injury prevention before and after implementing an educational intervention. Design/MethodA pre-and post-intervention study. Pre-intervention data collection involved administering an instrument, including demographic information, the Pressure Ulcer Knowledge Assessment Tool version 2, and the Attitudes towards Pressure Ulcer Prevention instruments. Following the analysis of pre-intervention data, an educational intervention was implemented. Post-intervention data were collected using the same instrument. SettingIntensive care units at three Saudi Arabian hospitals. Main outcome measuresNurses’ knowledge and attitudes towards pressure injury prevention. ResultsThe pre-intervention phase included 190 participants, and the post-intervention phase included 195 participants. Participants completed a paper-based survey at two different time points between June 2021 and March 2022. The mean pre-intervention scores for nurses’ knowledge and attitudes towards pressure injury prevention were 43.22% and 74.77%, respectively. Following the educational intervention, the knowledge and attitude scores increased significantly to 51.22% and 79.02%, respectively. Higher knowledge of pressure injury prevention was positively associated with positive attitudes towards prevention practices. Age, clinical nursing experience, and experience in intensive care units were identified as factors correlated with knowledge of pressure injury prevention. A Bachelor’s qualification or higher predicted better knowledge and attitudes towards pressure injury prevention. ConclusionsNurses’ knowledge and attitudes towards pressure injury prevention greatly improved following tailored, evidence-based education. The educational intervention featured multiple on-site bedside discussions, case studies, small-group presentations, and the provision of printed resources. Implications for Clinical PracticeNurses’ knowledge and attitudes towards pressure injury prevention should be examined, and education provided to ensure evidence-based prevention practices are implemented. Tailored small-group education sessions delivered conveniently could be an effective approach. Efforts should focus on attracting and retaining experienced, highly qualified nurses to ensure the adoption of evidence-based prevention practices.

Strategies to preventing pressure injuries among intensive care unit patients mechanically ventilated in prone position: a systematic review and a Delphi study.

Although the incidence of pressure injury in the prone position is high for the mechanically ventilated patients in the intensive care unit, evidence-based strategies are still lacking. To conduct a systematic review of current evidence, and to propose a series of strategies to prevent pressure injuries among mechanically ventilated patients with prone position in the intensive care unit. The study was guided by the Medical Research Council framework. After a systematic review of current evidence of original articles, guidelines, expert consensus and theories, a strategy draft was developed. Then we invited 20 experts to modify and refine these strategies through two rounds of Delphi consensus method. After two rounds of Delphi process, the importance of coefficient of variation (Cv) and Kendall's coefficient of concordance in the strategies repository were 0.067 and 0.311, respectively. And the operability of Cv and Kendall's coefficient of concordance in the strategy draft was 0.055 and 0.294, respectively. Ultimately, we established 31 strategies for including 7 themes (assess risk factors, assess skin and tissue, body position management, skin care, nutrition, preventing medical device-related pressure injuries, education and supervision). In addition, we also developed a strategy framework to clarify our strategies. According to the Medical Research Council framework, we developed 7 themes and 31 strategies to prevention prone-position pressure injuries among the intensive care unit mechanically ventilated patients. This study was considered to improve the clinical management of pressure injuries among prone position patients in the intensive care unit settings.

Current Perspectives on Pressure Injuries in Persons with Dark Skin Tones from the National Pressure Injury Advisory Panel.

Pressure injury (PI) development is multifactorial. In patients with dark skin tones, identifying impending PIs by visual skin assessment can be especially challenging. The need for improved skin assessment techniques, especially for persons with dark skin tones, continues to increase. Similarly, greater awareness of the need for inclusivity with regard to representation of diverse skin colors/tones in education materials is apparent. To provide current perspectives from the literature surrounding skin assessment and PI development in patients with dark skin tones. The following elements will be discussed through the lens of skin tone: (1) historical perspectives of PI staging from the National Pressure Injury Advisory Panel, (2) epidemiology of PI, (3) anatomy and physiology of the skin, (3) skin tone assessment and measurement, (4) augmented visual assessment modalities, (5) PI prevention, (6) PI healing, (7) social determinants of health, and (8) gaps in clinician education. This article highlights the gap in our clinical knowledge regarding PIs in patients with dark skin tones. Racial disparities with regard to PI development and healing are especially clear among patients with dark skin tones. Skin tone color assessment must be standardized and quantifiable in clinical education, practice, and research. This work is urgently needed, and support from private and governmental agencies is essential.

Application of self-made anti-pressure sore cotton cover in preventing facial pressure injury in patients with non-invasive ventilation

To observe the application effect of self-made anti-pressure sore cotton cover on the prevention of facial pressure injury in patients with non-invasive ventilation, and to explore the effective method of preventing facial pressure injury. A prospective study was conducted. Patients with mild to moderate respiratory failure and non-invasive ventilation admitted to the department of intensive care medicine of Harisen International Peace Hospital Affiliated to Hebei Medical University from March 2020 to August 2021 were enrolled, and they were divided into gauze pad group, foam dressing group and self-made anti-pressure ulcer cotton cover group by random number table method. Before wearing the ventilator mask, the gauze pad group and the foam auxiliary dressing group should fold or cut out the auxiliary dressing with the corresponding size and suitable for the patient's facial contour. In the self-made anti-pressure sore cotton cover group, the ventilator cotton cover could be worn only by selecting the cotton cover suitable for the patient's face shape, aligning the vent to the mouth and nose, and tying the fixed belt behind the ear. The incidence of facial pressure sore, the time required to connect man-machine interface (from the preparation of auxiliary dressing for pressure sores to the connection of ventilator) and the cost of dressing were compared among the three groups. A total of 150 patients with non-invasive ventilation were enrolled, with 50 patients in each group. Compared with the gauze pad group and the foam dressing group, the incidence of facial pressure sore in the self-made anti-pressure sore cotton cover group was significantly reduced [6.0% (3/50) vs. 44.0% (22/50), 12.0% (6/50), both P < 0.05], and the time required to connect the man-machine interface was significantly shortened (minutes: 5.0±1.5 vs. 10.0±1.5, 8.0±2.0, both P < 0.05), dressing cost was significantly reduced (yuan: 30±10 vs. 150±20, 118±29, both P < 0.05). Compared with the gauze pad and the foam dressing, the incidence of facial pressure sore in non-invasive ventilation patients with self-made anti-pressure sore cotton cover is lower, the time required to connect man-machine interface is shorter, and the cost of pressure sore prevention dressing is less, which is suitable for the prevention of facial pressure injury in non-invasive ventilation patients.

Safe Patient Handling and Pressure Injury Prevention for Patients With Delayed Sternal Closure.

Pressure injuries are associated with increased morbidity, mortality, and cost. Patients with delayed sternal closure after cardiac surgery are at increased risk of developing pressure injury because of their reduced mobility and inability to undergo complete skin assessment. Safe patient handling of patients with delayed sternal closure is challenging because of mobility restrictions, leading to increased risk for patient and staff harm. An interprofessional team composed of bedside nurses, ergonomic specialists, a wound ostomy continence nurse, and cardiothoracic surgeons developed a patient mobility protocol for patients with delayed sternal closure consisting of levitating the patient for thorough skin assessment and care. A multimodal educational strategy was used to disseminate the new protocol. Patient information was collected on the type of surgery, results of the levitation, completion of the skin assessment, and subsequent interventions. Staff injury related to this work was monitored. After implementation of the protocol, 84 levitations were performed including 50 patients. No staff injuries were reported. Comprehensive skin assessments and care were completed for 98% of patients. Five patients were identified with pressure injury development, and appropriate interventions were applied. A standardized patient mobility protocol for patients with delayed sternal closure that leveraged available equipment was successful in reducing the risk for injury among staff and patients. The protocol allowed assessment and care and thus also reduced the risk for pressure injury development in these patients. Development of an innovative protocol to safely mobilize patients with delayed sternal closure resulted in improved patient care and increased staff safety.