Implementation of a Medical Device Related Pressure Injury Prevention Bundle: A Multidisciplinary Approach

One in three pressure injuries in hospitalized adult patients are related to medical devices, and medical device related pressure injuries (MDRPIs) are the No. 1 cause of pressure injuries in pediatric populations. Current literature suggests that the highest percentages of pressure injuries from medical devices were on the head, face, neck, and lower extremities. 

Education and awareness related to MDRPIs for the bedside clinical staff (nursing, rehabilitation, and respiratory) had been initiated in 2018; however, prevention was not the initial focus of the efforts. WOC nurse bedside consultation occurred when hospital-acquired medical device related pressure injuries were discovered as part of this increased awareness and hospital policies. The WOC nursing team began to consider ways to prevent MDRPIs after a review of pressure injury prevalence revealed an increase from 21.6% MDRPIs (2018) to an average of 35% of MDRPIs in the first two quarters of 2019.

A quality improvement project was proposed to senior leadership and introduced to the staff. The steps included the development of a MDPRI prevention bundle with interventions specific to most frequent types of medical devices and involved the expansion of a multidisciplinary team approach for implementation. A series of case studies preceded the implementation of a MDRPI prevention bundle to demonstrate the effectiveness of the use of a five-layer silicone hydrocellular foam dressing.

This MDPRI prevention bundle, while in its infancy, will provide guidance for prophylactic use of a five-layer silicone hydrocellular foam dressing under medical devices and application of a polymer-based alcohol-free barrier film in certain patient populations.