Implementing a Pressure Injury Prevention Bundle to Decrease Hospital-Acquired Pressure Injuries in an Adult Critical Care Unit: An Evidence-Based, Pilot Initiative

Patients in critical care units (CCUs) are at risk of the development of hospital-acquired pressure injuries (HAPIs). Research supports the use of a pressure injury prevention (PIP) bundle to standardize PIP strategies and reduce the incidence of HAPIs. PURPOSE: This evidence-based practice initiative was undertaken to implement a PIP bundle to decrease HAPIs in an adult patient CCU. METHODS: A literature review was conducted during the first month of the implementation of the initiative to identify best PIP and bundle implementation practices. Wound, ostomy, and continence nurses conducted educational sessions and mentored registered nurses who became PIP bundle resource nurses. Adoption of the bundle was validated using an audit tool and PIP rounds. The pre- and post-implementation HAPI indices, pressure injuries / patient care days x 1000, were compared. RESULTS: Implementation of the PIP bundle resulted in a notable decrease in HAPIs on the unit. During the pre-intervention period, January 2017 to January 2018, there were 9 HAPIs (HAPI index 3.4). During the 10-month post-intervention period, 1 HAPI developed (HAPI index 0.48). CONCLUSION: An evidence-based PIP bundle initiative was implemented in an adult patient CCU to standardize the process for HAPI prevention and reduce the number of HAPIs. Staff involvement and leadership support were vital to the success of the initiative. Integration of the bundle into practice resulted in a notable decrease in HAPIs.