CSI Project

Is There Pressure Underneath?

Newark Beth Israel Medical Center (Newark, New Jersey)

CSI Summary

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Summary

CSI Presentation

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Presentation

CSI Toolkit

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Toolkit

Added to Collection

Project Topic:

Decreasing hospital-acquired pressure injuries (HAPIs)

Hospital Unit:

Cardiothoracic Intensive Care Unit (CTICU)

CSI Participants:

  • Morgan Bothe, BSN, RN
  • Dolly Casas-Zegarra, BSN, RN, CCRN
  • Jessica Cunha, BSN, BA, RN
  • Karolina Krupa, BSN, RN, CCRN
  • Nathaly Pineda-Gamez, BSN, RN, CCRN

Project Goals/Objectives:

  1. Educate staff to identify risk factors for skin breakdown and apply nursing interventions to prevent and treat pressure injuries
  2. Increase knowledge of pressure injury prevention among 90% of staff
  3. Implement an evidence-based HAPI prevention bundle
  4. Decrease HAPIs 20%

Project Outcomes:

  1. Decreased HAPIs 60% in patients with transplants, extracorporeal membrane oxygenation (ECMO) and ventricular assist devices (VAD)
  2. These outcomes resulted in a positive estimated annual fiscal impact of $208,866.

Project Overview:

Patients in our cardiothoracic intensive care unit (CTICU) face an elevated risk of developing hospital-acquired pressure injuries (HAPIs) attributed to factors such as compromised perfusion, use of vasopressors and mechanical devices, and limited mobility, To help minimize this risk, our CSI team implemented a project focused on increasing unit nurses’ knowledge of pressure injury prevention. Our strategy involved creating a skin injury prevention bundle form and providing unit-wide education.

The CSI team introduced our HAPI prevention project to the CTICU staff with an initial “pressure injury knowledge” assessment survey. Next, we held a kickoff celebration where we showcased HAPI prevention educational posters, served breakfast and announced a monthly gift card giveaway for the “Skin Champion of the Month.” After educating unit staff about the goals of our project, we introduced an “SSKIN” bundle and card to support HAPI prevention, conducted weekly skin prevalence rounding, and identified a Skin Champion of the Month.

At the six-month mark, our CSI team organized a redosing party to re-engage unit staff in HAPI prevention and reinforce our project goals. We also invited a bed company representative to provide in-services to help increase staff knowledge of the bed’s multiple features that assist with pressure injury prevention.

Our efforts resulted in a 60% reduction in HAPIs for CTICU patients with transplants, ECMO and VAD, with estimated annual savings to our hospital of nearly $209,000.

Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

Disclaimer
The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.