Medical Device-Related Pressure Injury (MDRPI) Prevention in the Intensive Care Unit (ICU): An Evidence Based Practice Quality Improvement Project
Doctor of Nursing Practice
Constance H. Glenn, DNP, MSN, APRN, FNP-BC, CNE
Michelle Saglimbene, MSN, RN, NEA-BC
Introduction: All intensive care unit (ICU) patients utilize various medical devices for care and treatment, placing them at high-risk for medical device-related pressure injuries (MDRPIs), which can lead to life-threatening infections, wounds/scars, and consumption of additional time and products to rectify these issues. Lack of appropriate decompression measures and improper bedside handoff report was recognized in the ICU at a hospital in Connecticut (CT).
Method: A literature search using CINAHL, MEDLINE, and the Cochrane Database of Systematic Reviews was conducted, restricting the search to the period between 2018-2022. The keywords searched were: “pressure injuries,” “adult patients,” “intensive care unit,” “educational intervention,” “prevention,” and “identification.” From an initial library of eight articles, the selection resulted in four articles by adding the keywords “medical device-related pressure injuries.” The Plan-Do-Study-Act (PDSA) cycle was used to create/conduct an educational simulation training highlighting preventative and treatment measures carried out on three ICU competency days. The ICU nurses learned to take lead by understanding risk factors, tailored prevention to the device type, and collaborated with other team members to ensure continuity of care and brought these skills to their daily bedside routine.
Results: A review of literature validated that staff education led to a positive impact on MDRPI prevention, decreased ICU stays pertaining to MDRPIs, and reduced costs and resources to correct these issues. The pre-survey, post-survey, and post-intervention results showed an increased perception on continuous skin assessments leading to an accurate account of MDRPI risk, and a drastic decrease in the number of MDRPIs in the ICU setting.
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Shah, S. (2023). Medical device-related pressure injury (MDRPI) prevention in the intensive care unit (ICU): An evidence based practice quality improvement project [Unpublished DNP project]. Sacred Heart University.
A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.