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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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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.