Translating Data into Practice: Device Related Pressure Ulcers

Purpose:
The purpose of this study is twofold: to quantify and describe the problem of device related pressure ulcers (DRPU) in acute care setting and translate the current DRPU data into best practice interventions for the bedside nurse.

Background/Significance:
Device related pressure ulcers account for a significant source of injury, reflecting 29-34.5% of all hospital acquired pressure ulcer (HAPU)(Black et al 2010, Apold & Rydrych 2012).Varying data collection methodologies were described in these reviews. Helping nurses make the connection between pressure ulcer occurrence and their delivery of best practice interventions improves care. We report on all occurrence of DRPU over a two year period in an 800 bed level-1 trauma/teaching hospital.

Methods:
Pressure ulcer data was extracted from electronic health record (ERH), validated by board certified Wound Care Specialist (WCS) and imported into data management files. Data collection was done using NDNQI quarterly prevalence and supplemented by actual occurrence (real time incidence). DRPU were then extracted and analyzed by location, stage and device. Policy, procedures and products were implemented into nursing care.

Results:
Data collection results showed, total number of DRPU (2010=46, 2011=86), most frequent stages (Stage II and Unstageable), and most frequent location (ears, nares, and bridge of nose). There was only 1 occurrence of Stage IV DRPU in the two years of data collection. Data collected supported previous research (Black et al 2010, Apold & Rydrych 2012). Despite surveillance and focused review of all DRPU by the WCS, the occurrences increased during the second year of collection. A key factor in nursing use of prevention interventions was product accessibility.

Conclusions and Implications for Practice:
Findings were consistent with previous DRPU research, except for increasing trends in DPRU and fewer worse stage ulcers. Early identification and product availability is key component in DRPU prevention and treatment