Practice Innovations
In the challenging environment of the Cardiac Intensive Care Unit (CICU), patients are at an increased risk of pressure injuries (PIs) attributed to compromised mobility, perfusion, and the utilization of lifesaving medical devices. These injuries not only inflict significant discomfort and scarring to patients but also contribute to increased cost, prolonged hospital stays, and diminished overall satisfaction. Recent statistics highlight the ICU population as particularly susceptible to PIs. Recognizing the urgency to address this issue, one urban hospital embarked on a Quality Improvement (QI) project to investigate the factors contributing to a suboptimal turning compliance rate of 67% in the CICU.
Methods:
Data collected from monthly Prevalence days over the preceding two years revealed patient positioning as a notably underperforming metric. Recognizing the critical need for improvement in this area, a series of strategic interventions were implemented to address the identified challenges. The interventions included standardizing turning times to even hours, conducting educational sessions for nursing staff, utilizing text reminders on nurses' phones, incorporating turning education in the orientation for new CICU nurses, and deploying visual turning signs at each bedspace. A medical record review of at-risk patients was performed post-interventions to assess improvements in compliance.
Results: Following the implementation of the QI interventions, the turning compliance rate in the CICU demonstrated a significant improvement, increasing from 67% to 89%.
Discussion: These results suggest that the combination of standardized turning practices, targeted education, and visual cues effectively enhanced compliance with the recommended turning regimen in the CICU, potentially reducing the incidence of pressure injuries and improving overall patient outcomes.