Other Titles

Device Manager: Implementation of a Bundle to Prevent Medical Device-Related Pressure Injuries [Poster Title]

Other Titles

Rising Star Poster/Presentation - Rapid Presentation Round

Abstract

Background: Pressure injuries (PIs) are a continuing global problem in healthcare and worse for critically ill patients, costing up to $30 billion annually in the United States and are not reimbursable. Medical devices provide life support and healing in hospitalized patients but can also cause harm. Approximately 30-60% of PIs come from medical devices, causing pain, discomfort, and patient dissatisfaction while worsening patient outcomes.

Problem: The practicum site saw increased MDRPIs over two years, over the hospital average, due to a lack of standardization and knowledge for preventing MDRPIs. This led to extended lengths of stay, increased healthcare costs, and poor patient outcomes.

Methods: A quality improvement project, guided by the Knowledge-To-Action framework, implemented an MDRPI prevention bundle over ten weeks in critically ill adults. Healthcare professionals were educated on the bundle for integration into clinical practice. An electronic audit tool collected observational data and electronic health record reviews to measure the incidence of MDRPIs. Descriptive and inferential statistics were used to compare pre-post rates.

Intervention: The literature supports using a bundle of evidence-based interventions endorsed by leading international organizations to prevent MDRPIs. An MDRPI prevention bundle aimed to prevent and reduce the rate of MDRPIs was proven reliable and valid in improving care processes and patient outcomes.

Results: Descriptive studies and Fisher’s exact test were performed. The incidence decreased from 1.17% to 0%. Although the pre-and post-intervention MDRPI rates decreased, computing a p-value for the post-intervention rate of 0 MDRPI was not meaningful or statistically significant. However, clinical significance proved meaningful.

Conclusions: The project revealed a reduction in MDRPIs with no statistical significance. Preventing PIs remains a high priority for healthcare organizations. Implementing an evidence-based bundle can prevent MDRPIs, reduce the rate of MDRPIs, standardize nursing care, and improve patient outcomes. The project led to bundle uptake across all critical care units in the healthcare system. Further research on the impact and value of nursing care is recommended.

Notes

References:
Gefen, A., Alves, P., Ciprandi, G., Coyer, F., Milne, C. T., Ousey, K., Ohura, N., Waters, N., Worsley, P., Black, J., Barakat-Johnson, M., Beeckman, D., Fletcher, J., Kirkland-Kyhn, H., Lahmann, N. A., Moore, Z., Payan, Y., & Schlüer, A. B. (2022). Device-related pressure ulcers: SECURE prevention. Second edition. Journal of Wound Care, 31(Sup3a), S1–S72. https://doi.org/10.12968/jowc.2022.31.Sup3a.S1

Jackson, D., Sarki, A. M., Betteridge, R., & Brooke, J. (2019). Medical device-related pressure ulcers: A systematic review and meta-analysis. International Journal of Nursing Studies, 92, 109–120. https://doi.org/10.1016/j.ijnurstu.2019.02.006

Monarca, M., Marteka, P. & Breda, K. (2018). Decreasing incidence of medical device– related pressure injuries in a small community hospital. Journal of Wound, Ostomy and Continence Nursing, 45(2), 137-140. https://doi.org/10.1097/WON.0000000000000419

Pittman, J., & Gillespie, C. (2020). Medical device-related pressure injuries. Critical Care Nursing Clinics of North America, 32(4), 533-542. https://doi.org/10.1016/j.cnc.2020.08.004

Tayyib, N., Asiri, M. Y., Danic, S., Sahi, S. L., Lasafin, J., Generale, L. F., Malubay, A., Viloria, P., Palmere, M. G., Parbo, A. R., Aguilar, K. E., Licuanan, P. M., & Reyes, M. (2021). The effectiveness of the SKINCARE bundle in preventing medical-device related pressure injuries in critical care units: A clinical trial. Advances in Skin & Wound Care, 34(2), 75–80. https://doi.org/10.1097/01.ASW.0000725184.13678.80

The Joint Commission. (2018). Managing medical device-related pressure injuries. (Quick Safety, 43). https://www.jointcommission.org/-/media/tjc/newsletters/qs-43-med-dev-pressure-injuries-7-17-18-final3.pdf

Siotos, C., Bonett, A. M., Damoulakis, G., Becerra, A. Z., Kokosis, G., Hood, K., Dorafshar, A. H., & Shenaq, D. S. (2022). Burden of pressure injuries: Findings from the Global Burden of Disease Study. Eplasty, 22, e19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275412/

Description

Pressure injuries are a pervasive problem in healthcare and up to 60% are caused by medical devices. Bundles are proven reliable to reduce medical device-related pressure injuries (MDRPIs). The purpose of this activity is to inform clinicians on the use of a bundle to reduce MDRPIs and improve patient safety.

Author Details

Sierra Holloway, DNP, RN

Sigma Membership

Non-member

Type

Poster

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Other

Keywords:

Pressure Ulcer Prevention, Pressure Ulcer -- Risk Factors, Critically Ill Patients

Conference Name

Creating Healthy Work Environments

Conference Host

Sigma Theta Tau International

Conference Location

Washington, DC, USA

Conference Year

2024

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-02-16

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Device Manager: Bundle Implementation for Reducing Device-Related Pressure Injuries

Washington, DC, USA

Background: Pressure injuries (PIs) are a continuing global problem in healthcare and worse for critically ill patients, costing up to $30 billion annually in the United States and are not reimbursable. Medical devices provide life support and healing in hospitalized patients but can also cause harm. Approximately 30-60% of PIs come from medical devices, causing pain, discomfort, and patient dissatisfaction while worsening patient outcomes.

Problem: The practicum site saw increased MDRPIs over two years, over the hospital average, due to a lack of standardization and knowledge for preventing MDRPIs. This led to extended lengths of stay, increased healthcare costs, and poor patient outcomes.

Methods: A quality improvement project, guided by the Knowledge-To-Action framework, implemented an MDRPI prevention bundle over ten weeks in critically ill adults. Healthcare professionals were educated on the bundle for integration into clinical practice. An electronic audit tool collected observational data and electronic health record reviews to measure the incidence of MDRPIs. Descriptive and inferential statistics were used to compare pre-post rates.

Intervention: The literature supports using a bundle of evidence-based interventions endorsed by leading international organizations to prevent MDRPIs. An MDRPI prevention bundle aimed to prevent and reduce the rate of MDRPIs was proven reliable and valid in improving care processes and patient outcomes.

Results: Descriptive studies and Fisher’s exact test were performed. The incidence decreased from 1.17% to 0%. Although the pre-and post-intervention MDRPI rates decreased, computing a p-value for the post-intervention rate of 0 MDRPI was not meaningful or statistically significant. However, clinical significance proved meaningful.

Conclusions: The project revealed a reduction in MDRPIs with no statistical significance. Preventing PIs remains a high priority for healthcare organizations. Implementing an evidence-based bundle can prevent MDRPIs, reduce the rate of MDRPIs, standardize nursing care, and improve patient outcomes. The project led to bundle uptake across all critical care units in the healthcare system. Further research on the impact and value of nursing care is recommended.