Using a Bundle Approach to Reduce Pressure Ulcers in an ICU

In acute care, Intensive Care Unit (ICU) patients face the greatest risk for development of pressure ulcers. An unexplained increase in the incidence of pressure ulcers in the ICU in a rural Midwest Magnet hospital led to the development of evidence-based initiatives to address this challenge to practice. In the 2 months prior to this project, 7 stage II pressure ulcers developed in the ICU. This initiative included education regarding significance and limitations of the Braden risk assessment in ICU, introduction of a pressure ulcer prevention bundle acronym, review of patient turning practices with emphasis on safe patient handling, and creation of an algorithm with interventions targeted to Braden subscales and highest risk ICU patients. In the 16 months following this project, 5 stage II pressures developed. No stage III or greated pressure ulcers developed in the 2 months prior to initiative or in the 16 months after initiative.

Jochem K, Weigand L

Keywords: pressure ulcer prevention, safe patient handling, Braden risk assessment tool