809 Culture Change in the Burn Unit: A Comprehensive Pressure Injury Reduction Strategy

• Published in: Journal of burn care & research Vol. 41; no. Supplement_1; p. S243
• Main Author: Werthman, Emily h
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 03-03-2020
• ISSN: 1559-047X; 1559-0488
• DOI: 10.1093/jbcr/iraa024.386

Abstract
Introduction
In our regional burn center, which treats approximately 800 patients annually, the prevention of pressure injuries continues to challenge the burn team. The nursing team, in particular, was demoralized by a steady prevalence rate despite utilizing evidence based practice. A comprehensive pressure injury reduction plan was developed to provide new strategies to prevent pressure injuries and to provide real time data about the effectiveness of nursing interventions.
Methods
A team of physicians, nurses, nutritionists, pharmacists, physical and occupational therapists developed a plan to encourage all members of the team to become active participants in pressure injury prevention. The first method was the introduction of a weekly pressure injury survey for all burn patients. This survey ensures any emerging pressure injury is recorded and appropriate interventions taken. Secondly, a new pressure mapping device was installed in all ICU beds in the burn center. The pressure mapping device provides data to nurses during patient repositioning. This important data demonstrated to nurses, in real time, if their offloading was effective. Lastly, a weekly pressure injury analysis provided root cause analysis of any pressure injuries discovered in weekly surveys. As a result, nurses were provided real time feedback about the effectiveness of prevention techniques.
Results
Reporting of pressure injuries increased over 50% in the first year of the program. In addition, since the inception of the weekly prevalence surveys, the burn center has not not had a pressure injury progress past a stage two. The overall prevalence of pressure injuries has dropped each quarter,
Conclusions
Providing nurses with real time feedback in the form of real time full body pressure mapping, weekly prevalence and pressure injury analysis allows nurses to quickly change prevention techniques to better offload patients. While pressure injury rates have decreased, nurse involvement in pressure injury prevention has increased.
Applicability of Research to Practice
Pressure injuries continue to pose a significant challenge to burn patients. Given the continuing emergence of pressure injuries, nurses in our burn center were left demoralized and dissatisfied with their evidence based practice. Providing nurses with real time data to support the effectiveness of their prevention techniques has dramatically changed the culture in our burn center. Nurses are now able to view real time data about their practice through pressure mapping, weekly surveys and pressure injury cause analysis. As a result, nurses are more engaged in the important work of pressure injury prevention.