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Reducing pressure injuries in critically ill patients by using a patient skin integrity care bundle (InSPiRE)
Coyer, Fiona Gardner, Anne Doubrovsky, Anna Cole, Rae Ryan, Frances Mary Allen, Craig McNamara, Greg
Coyer, Fiona
Gardner, Anne
Doubrovsky, Anna
Cole, Rae
Ryan, Frances Mary
Allen, Craig
McNamara, Greg
Abstract
Purpose
To test an interventional patient skin integrity bundle, the InSPiRE protocol, for reducing pressure injuries in critically ill patients in an Australian adult intensive care unit.
Methods
Before and after design: patients receiving the intervention (InSPiRE protocol) were compared with a similar control group who received standard care. Data collected included demographic and clinical variables, skin assessment, presence and stage of pressure injuries, and score on the Sequential Organ Failure Assessment (SOFA).
Results
Overall, 207 patients were enrolled, 105 in the intervention group and 102 in the control group. Most patients were men (mean age, 55 years). The groups were similar on major demographic variables (age, SOFA scores, intensive care unit stay). Cumulative incidence of pressure injuries was significantly lower in the intervention group (18.1%) than in the control group (30.4%) for skin injuries (χ21=4.3, P = .04) and mucous injuries (t = 3.27, P≤ .001). Significantly fewer pressure injuries developed over time in the intervention group (log rank = 11.842, df = 1, P≤ .001) and intervention patients had fewer skin injuries (> 3 pressure injuries/patient = 1/105) than did control patients (> 3 pressure injuries/patient = 10/102; P = .02).
Conclusion
The intervention group, receiving the InSPiRE protocol, had a lower cumulative incidence of pressure injuries, and fewer and less severe pressure injuries that developed over time. Systematic and ongoing assessment of the patient’s skin and risk for pressure injuries as well as implementation of tailored prevention measures are central to preventing pressure injuries.
Keywords
length of stay, intensive care, pressure ulcer, middle-aged, patient care bundles
Date
2015
Type
Journal article
Journal
American Journal of Critical Care
Book
Volume
24
Issue
3
Page Range
199-209
Article Number
ACU Department
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Coyer_2015_Reducing_pressure_injuries_in_critically_ill.pdf
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AM_Coyer_2015_Reducing_pressure_injuries_in_critically_ill.pdf
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All rights reserved
- Embargoed until 9999-12-31
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