No Pressure in Tufts Medical Center ICUs

Tufts Medical Center (Boston, Massachusetts)

CSI Summary

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CSI Presentation

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Project Topic

Pressure ulcer prevention

CSI Participants

Kelli Baldwin, RN
Florence Holmes, RN
Sandra Keenan, RN
Kristin Maguire, RN

Project Goals/Objectives

  1. To decrease the occurrence of ICU-acquired pressure ulcers by 30 percent
  2. To develop a structure and process for bedside nurses to describe the pressure ulcer (PU), as opposed to staging the ulcer
  3. To develop a comprehensive skin assessment form to capture existing pressure ulcers present on admission
  4. To identify devices causing pressure and replace them and/or reeducate clinicians

Project Outcomes

  1. Educated staff on and generated greater awareness of the importance of off-loading every two hours, proper pillow positioning and waffle boot positioning
  2. Tested new waffle boots with unsatisfactory outcomes; trials continue until a satisfactory product is identified
  3. Implemented use of an absorbent, atraumatic dressing on bridge of the nose for all patients with a biPap mask
  4. Decreased the number of pressure ulcers 50 percent
  5. These outcomes resulted in a savings of $129,540, with a projected annual fiscal impact of $518,160.

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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.

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.