Advancing the Culture of Safety: Strategies to Prevent Pressure Injuries

Prepared by IPRO HQIC

Pressure Injuries affect up to 3 million Americans and are a major source of MORBIDITY, MORTALITY, and INCREASED HEALTHCARE COSTS (AHRQ). Hospital Acquired Pressure Injuries (HAPI) can cause undue HARM and increase LENGTH OF STAY.

To improve the overall quality of care, it is important to implement measures to prevent the development of HAPIs. In this Lunch & Learn we will cover:

  • The pathophysiology of pressure injuries and how they develop.
  • How to appropriately identify patients’ pressure injury risk factors.
  • How the Central Maine Healthcare System successfully implemented evidence-based strategies that resulted in a significant decrease in HAPI rates.

The Interdisciplinary Care Team’s Role in Pressure Injury Prevention

Prepared by IPRO NQIIC

This resource guide provides education, evidence-based practices, and guidance on how to engage the interdisciplinary team to collaborate and improve the assessment, management, and prevention of pressure injuries. It is intended for use by healthcare providers who work with patients/residents who either have pressure injuries or are at risk of developing them. It will guide healthcare teams to implement effective pressure injury prevention practices through an interdisciplinary approach (AHRQ, 2023).

Preventing Pressure Ulcers in Hospitals

Agency for Healthcare Research and Quality (AHRQ)

This tool is an example of a clinical pathway, detailing the relationship among the different components of pressure ulcer prevention. This tool can be used by the hospital unit team in designing a new system, as a training tool for frontline staff, and as an ongoing clinical reference tool on the units. This tool can be modified or a new one created to meet the needs of your particular setting. If you prepared a process map describing your current practices, you can compare that to desired practices outlined on the clinical pathway.

Skin Manifestations with COVID-19

National Pressure Injury Advisory Panel (NPAIP)

Many reports are occurring concerning areas of purpuric/purple skin and purple toe lesions in patients diagnosed with COVID-19 (SARS-CoV-2). Wound care providers are being asked if these skin lesions are forms of Deep Tissue Pressure Injury and/or “skin failure”. Early reports of COVID-19 related
skin changes included rashes, acral areas of erythema with vesicles or pustules (pseudo-chilblain), other vesicular eruptions, urticarial lesions, maculopapular eruptions, and livedo or necrosis. The pattern and presentation of skin manifestations with COVID-19 is more than rashes. The purpose of this paper is to guide the wound care clinician in determining if the “purple skin” being seen is a deep tissue pressure injury or a cutaneous manifestation of COVID-19.

Unavoidable Pressure Injury during COVID-19 Pandemic: A Position Paper from the National Pressure Injury Advisory Panel

National Pressure Injury Advisory Panel (NPIAP)

The purposes of this National Pressure Injury Advisory Panel (NPIAP) Position Paper are to:

  1. Summarize the current NPIAP position regarding unavoidable pressure injuries.
  2. Examine the effects of the COVID-19 crisis on the scope of what is considered an unavoidable pressure injury.
  3. State the position of the NPIAP regarding determinations of unavoidable pressure injuries during the COVID-19 crisis.
  4. Renew the NPIAP call to collaborate on the development of criteria for the determination of unavoidable pressure injuries in acute care.

Unavoidable Pressure Injury during COVID-19 Pandemic: A Position Paper from the National Pressure Injury Advisory Panel

National Pressure Injury Advisory Panel (NPIAP)

The purposes of this National Pressure Injury Advisory Panel (NPIAP) Position Paper are to:

  1. Summarize the current NPIAP position regarding unavoidable pressure injuries.
  2. Examine the effects of the COVID-19 crisis on the scope of what is considered an unavoidable pressure injury.
  3. State the position of the NPIAP regarding determinations of unavoidable pressure injuries during the COVID-19 crisis.
  4. Renew the NPIAP call to collaborate on the development of criteria for the determination of unavoidable pressure injuries in acute care.

NUTRITION & IMMUNITY PODCAST SERIES: Pressure Injury

Abbott Nutrition Health Institute (ANHI)

Panel of world-renowned experts discuss nutrition guidelines for caring for COVID-19 patients.

  • NUTRITION CARE FOR PRESSURE INJURIES: GUIDELINES TO OPTIMIZE OUTCOMES
  • THE ROLE OF HYDRATION IN ACUTE INFLAMMATORY PROCESS & RECOVERY
  • NATIONAL BLUEPRINT: ACHIEVING QUALITY MALNUTRITION CARE FOR OLDER ADULTS, 2020 UPDATE
  • NUTRITION SUPPORT OF THE COVID-19 ICU PATIENT
  • A REVIEW OF THE SCCM/ASPEN COVID-19 RECOMMENDATIONS
  • NUTRITIONAL NEEDS OF COVID-19 PATIENTS IN-HOSPITAL & POST-DISCHARGE