Under Pressure: Reducing Hospital-Acquired Pressure Ulcers in the MICU

Brigham and Women’s Hospital (Boston, Massachusetts)

CSI Summary

Available only to registered AACN.org users.

CSI Presentation

Available only to registered AACN.org users.

CSI Toolkit

Available only to users with a paid AACN membership.

Added to Collection

Project Topic

Pressure ulcer prevention

CSI Participants

Beth Melanson, RN, MSN, CCRN
Meg Nemitz, RN, BSN, CCRN
Katie O'Connell, RN, BSN
Kim Pritchard, RN, CCRN

Project Goals/Objectives

  1. To reduce hospital-acquired pressure ulcer (HAPU) prevalence in the MICU 40 to 50 percent
  2. To provide pressure ulcer prevention and practice change education to 80 percent of nursing and Patient Care Assistant (PCA) staff
  3. To increase adherence to pressure ulcer bundle components
Project Outcomes
  1. Decreased the HAPU prevalence rate reported to Massachusetts Patient Care Link from 33.3 percent in March 2013 to 10.5 percent in December 2013 (68 percent reduction)
  2. Decreased HAPUs by five in the 19 weeks post educational intervention, for a projected annual fiscal impact of $590,884
  3. Decreased sacral/coccyx/gluteal cleft HAPUs by five in eight weeks as a result of the Mepilex border sacrum trial, for a projected annual fiscal impact of $1,403,350
  4. Achieved 100 percent attendance of staff during three education days (84 percent overall of permanent MICU staff and several float RNs)
  5. Increased average off-loading during 24 hours from seven times prior to staff education to eight times post education (less than target of 10 times)
  6. Average 60 percent adherence to the "four eyes on admission" process
  7. These outcomes resulted in a combined projected annual fiscal impact of $1,994,234.

Sign in to AACN.org to download the complete presentation and project summary. Not an AACN.org registered user? Sign up today.

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.