Self Proning Kits to Reduce Hospital Acquired Pressure Injuries in Covid 19 Patients

Authors: Marissa A. Hudler MSN, RN, WCC, OMS, CFCN; Agnes J. Cadena BSN, RN, WCC; Asresash H. Admassie BSN, RN, WCC; Lynda M. Narvaez, MSN Ed, RN, CWON; and Jeffrey Framnes BSN, RN
 
Poster Number: EBP-011
 
In July 2021, there was an increase in hospital-acquired pressure injuries (HAPIs) in patients with COVID-19 who were self-proning (SP). These patients had to self-prone to improve breathing and oxygen saturation for multiple hours a day. The purpose of this study was to reduce the number of HAPIs by developing a kit for these patients. Hospital-acquired pressure injuries were developing in SP patients without pressure injury (PI) prevention measures. Before implementing the kits, the HAPI rate in SP patients with COVID-19 for July 2021 was 0.48 per 1000 patient days.
 
Physicians, nurses, respiratory therapists, and wound care collaborated to assess best practices and products for prone patients. The development of SP kits included silicone foam dressings, static air cushions, breathable moisture-wicking foam, and a head positioner. Wound care and nursing collaborated to make grab-and-go kits for staff to give to SP patients. Health care providers educated patients on the SP kit and assisted with application use of the kits. The goal was early recognition of SP patients and implementation of the kit to reduce the number of HAPIs.
 
The interventions took place in August 2021. An education plan included in-services, educational flyers, and product guides for physicians, nursing, respiratory therapists, and wound care on contents and use of the kits. A cart in the supply room with premade kits and staff awareness of the importance of adopting and integrating SP kits reduced the number of HAPIs in patients with COVID-19.
 
In August 2021, the HAPI rate decreased to zero, and there has not been a HAPI since the development and implementation of the SP kits. Kit use was implemented on one hospital unit and has spread to multiple units across the organization, with the increased knowledge of prevention measures for SP patients.
 
References:
Martel T, Orgill DP. Medical device–related pressure injuries during the COVID-19 pandemic. J Wound Ostomy Continence Nurs. 2020;47(5):430-434.
Perrillat A, Foletti J-M, Lacagne AS, Guyot L, Graillon N. (2020). Facial pressure ulcers in COVID 19 patients undergoing prone positioning: how to prevent an underestimated epidemic? J Stomatol Oral Maxillofac Surg. 2020;121(4):442-444.
Smart H. Strategies for pressure injury prevention in patients requiring prone positioning. Adv Skin Wound Care. 2021;34(7):390-391.
 
Poster reference:
Hudler MA, Cadena AJ, Admassie AH, Narvaez LM, Framnes J. Self proning kits to reduce hospital acquired pressure injuries in Covid 19 patients. Poster presented at: Symposium on Advanced Wound Care Spring; April 6-10, 2022.