Introduction: Patients in the Intensive Care Unit (ICU) are at high risk for Hospital Acquired Pressure Injuries (HAPI) due to their comorbidity. At Doctors Hospital ICU, it was identified that patients were not being turned in a timely manner. This resulted in patients remaining in the same position for an extended period of time, therefore increasing the chances of developing skin breakdown. For the fourth quarter of fiscal year 2016, the ICU had four pressure injuries to the sacrum and heels resulting in a rate of 3.98 based on patient days.
Methods: In response to the high incidence of HAPI’s in the ICU, a member of the Unit Practice Council created an interdisciplinary turn team. The purpose of the turn team was to share the responsibility of repositioning all patients on the unit with a Braden Scale score of 18 or less. Using the CETEP Model to guide the EBP project, the team came together and developed a plan which included several components. For example, a white board was designated with time slots every two hours. Two staff members were to sign up for every time slot. Staff members were given the opportunity to choose their preferred time slot at the beginning of their shift. Audits were performed daily for the first month to ensure staff compliance with repositioning patients.
Results: The interdisciplinary turn team successfully reduced HAPIs to the torso and extremities in the ICU by 100%. For fiscal year 2017, we had zero occurrences of pressure injuries to the torso or extremities. It is evident that the interdisciplinary turn team promotes teamwork and improved patient outcomes.
Discussion: The ICU implemented evidence based practice to create the interdisciplinary turn team. Members that participate in the turn team are direct care nurses, clinical partners, respiratory therapists, patient care supervisors and the patient care manager which have created a team approach in reducing HAPIs. The success of the ICU’s interdisciplinary turn team demonstrates the need to take a collaborate approach to improving patient outcomes.
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Menendez, Jessenia; Madrigal, Isabel; and Agudelo-Doval, Jennifer, "An Interdisciplinary Team Approach to Reducing HAPIs" (2018). All Publications. 2830.
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