Interdisciplinary Collaboration to Reduce Medical-Device Related Pressure Injuries in Covid-19 Patients

Introduction; In July 2021, there was an increase in medical device-related pressure injuries (MDR PI) from respiratory equipment in patients with Covid-19.

The purpose is to reduce the number of MDR PI by accurately identifying and preventing pressure injuries.

A collaborative interdisciplinary approach using education and early implementation of MDR PI prevention measures in critical care patients with Covid-19. Nurses and respiratory therapists (RT) lack knowledge on preventing MDR PI from respiratory equipment. Before implementing MDR PI prevention measures to all respiratory equipment, the MDR PI rate for July 2021 was 0.49 per 1,000 patient days.

Methods: The wound care team collaborated with leadership, nursing staff, and RT to adopt a workflow to add MDR PI prevention measures to all respiratory equipment on the initial application. The goal was early recognition of at-risk patients and implementation of MDR PI prevention measures on respiratory equipment to reduce the number of MDR PI. The interventions took place in August 2021.

A formal train-the-trainer education plan included in-services and one-on-one education during rounding on applying MDR PI prevention measures with nursing and RT staff. Education flyers, product guides, and respiratory therapists raised staff awareness on the importance of adopting and integrating MDR PI prevention measures when initially applying respiratory equipment. Daily rounding and skin assessments were completed with RT and wound care on Covid-19 patients with respiratory equipment to monitor the use of PI prevention measures.

Results: In August 2021, the MDR PI rate increased to 1.25 due to a surge in Covid-19 patients, staff awareness, and travel RT’s. After collaboration on implementing PI prevention education and applying prevention measures to all respiratory equipment, the MDR PI rate decreased to 0.50 in September 2021, 0.27 in October 2021, and zero in November 2021.

Discussion: Using interdisciplinary collaboration with RT, nursing staff, and wound care to reduce MDR PI in Covid-19 patients developed a workflow that included accurate identification and early implementation of PI prevention on respiratory equipment. Increased knowledge and collabration on preventing MDR PI in Covid-19 patients decreased the PI rate from 0.49 in July 2021 to zero in November 2021.