Reducing Tracheostomy Medical Device-Related Pressure Injury: A Quality Improvement Project.

IF 2 Q2 NURSING AACN Advanced Critical Care Pub Date : 2022-12-15 DOI:10.4037/aacnacc2022874

Hazel Holder, Brittany Ray Gannon

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引用次数: 1

Abstract

Objective: To reduce the incidence of medical device-related pressure injuries associated with tracheostomies performed with the percutaneous dilation technique using a standardized multidisciplinary intervention.

Methods: The intervention was developed using the Agency for Healthcare Research and Quality Preventing Pressure Injuries Toolkit. A fenestrated polyurethane foam dressing was sutured in place under the tracheostomy flange during insertion to reduce the risk of medical device-related pressure injuries. The sutures were removed in pairs over a period of 7 to 10 days.

Results: Comparison of data from 2018 to 2021 demonstrated a decrease in the incidence of tracheostomy medical device-related pressure injuries from 13% to 0% in the first year, which was maintained for the following 3 years. This improvement was supported by electronic medical record audits, daily interdisciplinary rounds, weekly practice assessments, and primary nurse evaluations.

Conclusion: Implementation of a standardized process, supported by an interdisciplinary clinical team, can reduce medical device-related pressure injuries among patients undergoing percutaneous dilation tracheostomy.

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减少气管切开术医疗器械相关压力损伤:一个质量改进项目。

目的:采用标准化的多学科干预方法，降低经皮气管扩张术中气管造口术中医疗器械相关压力损伤的发生率。方法:采用卫生保健研究和质量预防压力伤害工具制定干预措施。在气管造口法兰下缝合有孔聚氨酯泡沫敷料，以减少医疗器械相关压力损伤的风险。缝合线在7至10天内成对拆除。结果:2018年至2021年的数据比较表明，气管切开术医疗器械相关压力损伤的发生率在第一年从13%下降到0%，并在随后的3年保持不变。这一改进得到了电子病历审计、每日跨学科查房、每周执业评估和初级护士评估的支持。结论:在跨学科临床团队的支持下，实施标准化流程可以减少经皮气管扩张切开术患者的医疗器械相关压力损伤。

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来源期刊

AACN Advanced Critical Care NURSING-

CiteScore

2.10

自引率

4.50%

发文量

期刊介绍： AACN Advanced Critical Care is a quarterly, peer-reviewed publication of in-depth articles intended for experienced critical care and acute care clinicians at the bedside, advanced practice nurses, and clinical and academic educators. Each issue includes a topic-based symposium, feature articles, and columns of interest to critical care and progressive care clinicians. AACN Advanced Critical Care contains concisely written, practical information for immediate use and future reference. Continuing education units are available for selected articles in each issue. AACN Advanced Critical Care is an official publication of the American Association of Critical-Care Nurses.

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