Pressure injury prevention in adult critically ill patients: best practice implementation project
Aline de Oliveira Ramalho, Leidiane Moreira Santiago, Luciana Meira, Alessandra Marin, Larissa Bertacchini de Oliveira, Vilanice Alves de Araújo Püschel
Abstract
OBJECTIVE: This study assessed compliance with the best practices for pressure injury prevention among ICU patients at a tertiary hospital in São Paulo, Brazil. INTRODUCTION: Intensive care patients are at high risk of developing a pressure injury; preventing this requires a best practice protocol. METHOD: This best practice implementation project was conducted in a Brazilian tertiary hospital in three phases following the JBI Model of Evidence-based Healthcare. Ten criteria derived from the best available evidence were audited and monitored before and after best practice implementation. RESULTS: The baseline and follow-up audits evaluated 28 patients at each step. A total of 448 h of care were analyzed using a monitoring camera and medical records. Compliance with all 10 audited criteria increased, with a 50% reduction in the prevalence of pressure injuries in intensive care. Of the 223 employees, 71% claimed to have some knowledge of pressure injury prevention, and 66% reported adequate adherence to prevention protocols. CONCLUSION: The audit and feedback strategy improved compliance with the criteria. Future audits are needed to promote the sustainability of evidence-based practice.