CSI: Clinical Skin Investigators

Project Topic:

Decreasing medical device pressure injuries

Hospital Unit:

Cardiothoracic Intensive Care Unit (CTICU)

CSI Participants:

• Rachel Di Lieto, BSN, RN
• Brianna Dwyer, BSN, RN, CCRN-CSC-CMC, CV-BC
• Christiana Poli, BSN, RN
• Sabrina Sloan, BSN, RN, CCRN

Project Goals/Objectives:

1. Implement new policy/standard of care for nurses to decrease medical device-related pressure injuries
2. Reduce hospital costs and length of stay
3. Increase patient satisfaction
4. Decrease incidence of medical device-related pressure injuries 50%

Project Outcomes:

1. Introduced new nursing policy/standard of care for decreasing medical device-related pressure injuries
2. Reduced costs and length of stay associated with medical device-related pressure injuries
3. Decreased incidence of medical device-related pressure injuries 60% (from 18 to 7)
4. Decreased incidence of non-device-related pressure injuries 61% (from 20 to 8)
5. These outcomes resulted in a positive estimated annual fiscal impact of $500,457.

Project Overview:

The year before beginning our CSI project, patients in the Stony Brook University Hospital CTICU experienced 48 pressure injuries, 20 of which were related to medical devices. Our CSI team decided to focus on a project that would help decrease device-related pressure injuries. We designed and implemented a staff education program about nursing care interventions that help prevent medical device-related pressure injuries.

First, our CSI team met with Stony Brook’s certified wound and ostomy nurse, nurse scientist and respiratory therapists. We discussed evidence-based articles on device-related pressure injuries to guide our research and generate ideas for our project. Next, the team distributed a pre-project skin survey to staff to obtain baseline data on their knowledge of pressure injuries.

To support the nurses working on our unit, the CSI team created a medical device skin care bundle and a wound care cart. The cart provided easy access to the supplies and interventions included in the new skin care bundle. To remind our colleagues about the importance of proper skin care and our project, we distributed badge buddies for staff nurses and posted educational flyers around the unit. Our team also conducted a “redosing event,” where we reeducated current staff and educated the new hires about our project and patient interventions.

Our efforts led to a 60% decrease in the rate of medical device-related pressure injuries and saved our hospital an estimated $500,000 annually. Our goal is to roll out these successful practices in other hospital units.