Pressure injuries are skin breakdowns resulting from prolonged pressure over a bony prominence or under medical devices. They can occur alone or in combination with shear or friction on the skin. Patients at highest risk are those who are unable to turn or reposition themselves in a bed or chair, are underweight, and have had involuntary weight loss (i.e., 10% in six months).
Prevention of pressure injuries includes completing risk assessments, daily skin assessments, early identification of skin breakdown, and implementing necessary treatments to prevent worsening of the skin injury. However, some pressure injuries are unavoidable, and can develop among critically ill patients with poor perfusion, malnutrition, or infection.
How is The Queen’s Health System Performing Compared to the Nation?
Pressure injuries are included in nursing sensitive indicators and directly reflect the quality of nursing care. At The Queen’s Medical Center, Quality and Patient Safety reports the percentage of all patients who acquire a pressure injury in the facility by conducting a quarterly Pressure Ulcer Prevalence Survey. Results are reported to the National Database of Nursing Quality Indicators (NDNQI). The data is compared to similar sized hospitals on a national level. Our target is based NDNQI benchmarks. The intention is use this data to identify opportunities for improvement to ensure patients continue to receive quality care.
Data
What Are We Doing to Prevent Pressure Injuries?
Upon admission to the hospital, all patients are comprehensively assessed to determine their risk for developing pressure injuries. Based on the patient’s risk, a variety of interventions are incorporated into their care plan (e.g., routine skin inspection, specialty surfaces, frequent turning and repositioning, addressing moisture, eliminating friction and shear, and providing nutritional support). The Queen’s Medical Center has a long standing committee focused on pressure injury prevention to include interventions and treatments. Unit-based skin champions are experts providing on-going education to staff so they remain current and providing best-practice quality care. Our wound team provides consultation and oversee the prevention, staging, reporting, and treatment of pressure injuries.
