Save our skin: A pressure injury reduction project targeting pressure injuries acquired in the intensive care unit

Abstract

Background Despite a process of rigorous investigation of the cause of severe pressure injuries (PIs) and implementing specific interventions, the number did not decrease in our adult intensive care unit (ICU). The aim of this project was to reduce the incidence of stage III and IV PIs acquired in the ICU and associated costs. Methods A Plan-Do-Study-Act (PDSA) quality improvement approach incorporating thorough ICU-wide multicomponent broad skin care/hygiene focused intervention and a multifaceted communication strategy (Save Our Skin: SOS) was used. The project was conducted in a 600-bed tertiary referral hospital in Sydney, Australia from 2015 to 2019. The main outcomes were the number of ICU-acquired stage III and IV PIs and costs associated with treating PIs per annum, and the number of severe PIs per 1,000 ICU bed days. Results There was a sustained decrease in the incidence of PIs (52 during 2014 and four during 2018). The number per 1,000 ICU bed days decreased; 2.57 during 2014 and 0.29 during 2018, with lower costs associated with the treatment of stage III and IV PIs. Conclusions This pragmatic multicomponent ICU-wide PI prevention project resulted in sustained outcomes in our ICU and cost savings.