Use of a Patient Monitoring System as an Innovative Intervention in a Pressure Injury Prevention Initiative in a Surgical Intensive Care Unit

Background: Pressure injuries (PI) have a major impact on patients and facilities in the United States with an approximate cost of $11 billion annually. Due to multiple factors, such as immobility and compromised perfusion, ICU patients are particularly susceptible to hospital-acquired pressure injury (HAPI).

Objective: The objective was to decrease HAPIs in a 12-bed surgical ICU in a mid-sized teaching hospital.

Methods: The initiative was multifaceted and addressed various factors contributing to HAPIs. The interventions included an algorithm for turning hemodynamically unstable patients, timely extubation with early and progressive mobility, staff education on proper positioning for offloading and use of PI prevention devices, and administrative accountability for standard of care in PI prevention. As a final intervention, an innovative patient monitoring system was installed. Patients at increased risk for HAPI were outfitted with a noninvasive sensor which communicated with wireless antennas. A central monitor displayed the position of the patient and alerted staff when the patient was scheduled to be repositioned.

Results: Over 10 months prior to the initiative, the unit had 17 HAPIs. Since the initiative, the unit had 15 HAPIs in 17 months. Prior to the patient monitoring system, the unit had eight HAPI in eight months related to turning and repositioning. Since the initiation of the patient monitoring system, the unit had three HAPIs in nine months related to turning and repositioning.

Discussion: The incidence of HAPI decreased from a mean of 1.7 to 0.88 injuries per month with this initiative. The patient monitoring system decreased the incidence of positioning-related HAPIs from a mean of 1 to 0.33 injuries per month. Prevention of HAPIs remains a domain of patient care requiring research and innovation. The results of this small sample study served to increase awareness of an evolving appreciation for patient mobility.