(PI-008) WAR ON WOUNDS: Reducing Hospital Acquired Pressure Injuries After the Pandemic
Introduction: Utilizing our War on Wounds strategy (WOW) at our acute care facility resulted in a decrease in hospital acquired pressure injuries (HAPIs) pre pandemic. However, maintaining pressure injury prevention interventions (PIPI) through the pandemic has been difficult. Critical staffing shortages resulted in fewer core staff, increase in travelers' and new grads were completing clinicals in a virtual simulated environment versus bedside hands-on nursing. This compounded with emergency charting implemented to relieve nursing burden continues to have a significant negative impact on PIPI and documentation as we emerge from the pandemic. Raising PIPI awareness and education to include essential documentation along with all the other priorities has never been more challenging.
Methods: Through 2022 as COVID surges decreased we were able to refocus on our educational strategies and tools to coach nursing staff. With leadership and quality dept support we continually tracked and monitored our HAPI rates and NDNQI Skin Survey data including chart reviews. This enabled us to identify opportunities for education to mitigate risk and celebrate areas of best practice. The DMAIC framework was used to guide our process improvement project: Define, Measure, Analyze, Improve, Control
Results: Analyzing and comparing our data 2018 thru 2022 we had a 60% HAPI reduction with zero heel pressure injuries through 2022 in the ICU. Comparing our HAPI numbers we noted a reduction of 46 HAPIS thru 2022 compared with 2021. Based on a conservative HAPI cost of 20K per HAPI, this resulted in a cost saving of more than $900K. We also noted improved staff engagement through our WOW educational offerings.
Discussion: Although there is lots of room for improvement, we have learned the importance of continual data collection and education especially as we emerge from the pandemic. This has enabled us to make accurate comparisons and identify where we need to focus. Reducing HAPIs is paramount, but our data reveals that our documentation remains our greatest liability. Moving forward this will be our key focus.
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