Decreasing Medical Device-Related Pressure Injuries on the Burn Unit

Abstract

Introduction: Medical devices are crucial for patient care, but misuse can lead to emotional and physical harm. Medical device-related pressure injuries (MDRIs) are preventable injuries that create a cost burden for the organization by impacting service reimbursement and burdening patients by extending hospital stays and increasing infection risks. Burn patients, in particular, are at a high risk of injury due to changes in sensory function related to the degree of sustained burn injury. These preventable injuries remain recurrent on a twenty-bed mixed acuity burn unit. In 2022, there were three MDRIS, and in 2023, four MDRIs occurred. Purpose: of this project was to implement an evidence-based guideline created by a multidisciplinary team to increase nurse documentation and decrease MDRIs in burn patients. Method: Based on the patient's Braden Scale Score of low, moderate, or high-risk risk of injury, nurses documented a set of evidence-based interventions as noted per the guideline. A pre/posttest was given to staff to evaluate knowledge. The PARIHS framework was used to support this intervention. Strategies and tactics used for project success included identifying key stakeholders and project champions and holding monthly meetings with staff to give/receive feedback. Data Collection: The primary outcome measure was Zero MDRIs. The secondary outcome included an increase in documentation of the Braden Scale and JH-HLM score, daily weights, guideline interventions, and 4 eyes in 4 hours. The process measure included the number of charts with completed guideline documentation. Ten charts were audited a week by the project leader. Data was analyzed using run charts with reports of aggregate data to stakeholders for feedback, reinforcement, and results. Results: Concluded zero MDRIs occurred during implementation. Results also indicated a documentation increase of the Braden Scale by 21%, the JHHLM score by 46%, guideline interventions by 32%, daily weights by 5%, and 4 eyes in 4 hours by 3%. Results indicate that standardized guidelines can prevent MDRIs and improve patient outcomes. Conclusion: Data suggests that the guideline should be a standard of care for all patients. The standardized guideline can increase nurse documentation and prevent MDRIs. If any changes were made, all traveling, and float staff will receive education prior to working on the unit.