Color Blind Clarity: Preventing Pressure Injuries using Thermography in Long Term Acute Care Hospitals

Introduction: Patients with darker skin tones are at risk for DTPI’s at almost double the rate of patients with lighter skin.1 With racial diversity increasing across the US, and an estimation that darker pigmented nationalities will comprise over half of the population by 2050 2, utilizing skin assessment protocols that reduce disparity is imperative. Long-wave infrared thermography (LWIT) is a multimodal technology used for the early detection of deep tissue pressure injuries (DTPIs) and wound measurement. Using LWIT allows for earlier recognition of skin abnormalities in patients of color leading to timely prevention efforts and treatment. With goals of decreasing hospital-acquired pressure injuries (HAPI), standardizing wound assessment, and decreasing disparity in healthcare, LWIT was implemented in ten Long term Acute Care Hospitals.Methods:Social Determinants of Health (SDOH) reveal potential disparities for patients of color. These disparities have a negative impact on outcomes; therefore, a standard of care was implemented requiring LWIT images within 24 hours of admission and weekly, for patients having a Braden score of 12 or less. An individual care plan was implemented including evidence based prevention and/or treatment bundles. Materials: Hand-held, photographic, and LWIT device and software: Non-radiating, non-invasive, and non-contacting Photographic documentation and accurate and repeatable wound size measurements LWIT reveals physiologic markers and objectively visualizes and quantitatively measures circulation, perfusion, and metabolic activity Results:The Fiscal year 2023 prevalence rate decreased to 0.12, from 0.94 fiscal year 2022.Discussion: Understanding SDOH utilizing thermography guides early detection and management of pressure injuries on patients with darker pigmented skin tones. This improved clinical outcomes, transcending disparity in wound management as evidenced by the cases illustrated. Clinician and patient education involving LWIT increased compliance with the care plan and supported patient participation. Don't be color blind - cultivate objective color awareness with thermography.References:1. Sommers M. Color awareness: Amust for patient assessment. Published January 11, 2011. Accessed October 9, 2023. https://www.myamericannurse.com/color-awareness-a-must-for-patient-assessment/ 2. Black J, Cox J, Capasso V, et al. Current Perspectives on Pressure Injuries in Persons with Dark Skin Tones from the National Pressure Injury Advisory Panel. AdvSkin Wound Care. 2023; 36(9): 470-480. DOI: 10.1097/ASW.0000000000000032. EPUB 2023 AUG 7. PMID: 37590446 3. Black J. Using thermography to assess pressure injuries in patients with dark skin. Nursing; 2018; 48(9): 60–1.