Utilizing a Comprehensive Wound Care Team to Lower Hospital-Acquired Pressure Injuries in an Academic Public Hospital

Background: Hospital-acquired pressure injuries have significant impacts on patient morbidity and mortality, with approximately 2.5 million patients treated for pressure related injuries each year.1 These wounds pose large healthcare challenges and increased expenditures, at an estimated $11 billion annually.1 This study aims to describe how a comprehensive wound care team at an academic public hospital system has impacted iatrogenic pressure injuries over an 8-year period. 

Methods: This retrospective review collected inpatient data on all hospital-acquired pressure injuries from May 2012 through February 2020. Information regarding wound staging, location, medical device location if applicable, and modifiable risk factors were recorded by the comprehensive wound care team. A statistical analysis using a one-way analysis of variance (ANOVA) was performed to assess for significance of mean number of cases, National Pressure Injury Advisory Panel (NPIAP) stage on initial presentation, and mean number of device-implicated wounds by year.  

Results:  A total of 957 patient cases were included. The average stage of pressure injury on assessment was 2.18, with the mean NPIAP stage declining from 2012 to 2020 (P = 0.003). Approximately 33.0% of pressure injuries were attributed to medical devices, with the most commonly implicated device being endotracheal tubing. The number of medical device induced wounds declined over the study time frame (P = 0.003). The most common site of injury was the sacrum (33.6%) and most injuries occurred in the intensive care unit setting (45.0%). 

Conclusion: Creation of a comprehensive wound care team within this academic public hospital system demonstrated a statistically significant decline in both device-acquired and pressure injury cases over the past 8 years. The wound care team has focused on frequent assessment, education of medical teams, implementation of protocols, and evidenced-based treatment to lower these pressure injury events and contribute to decreasing hospital expenditures.