Decreasing Hospital Acquired Pressure Injuries Through Photo Documentation

Evidence shows that patients who are on ICU floors have several factors that also put them at high risk of developing PI's. In fact, they found that the "probability of developing a pressure injury for patients on ICU's was 1-5 (95% CI 1.2-1.7) times higher than it was for patients in wards." (Lahmann, Knottner, Dassen, Tannen, 2011, p.358) Because patients admitted to IMR have high risk factors and often come from ICU's, we decided, in corroboration with new CMS regulations, to have detailed photo documentation of skin upon admission and discharge for every patient. Our process heavily focuses on initial recognition of PI's upon admission to our unit and correctly identifying other wounds. Taking photo's of wounds/PI on admit allows for ready and immediate access for the whole team to see and therefore treat the wound effectively. We include a ruler in the photo for easier comparison of size and improvement of wounds. If there are PI's we utilize the app to take weekly photo's to easier visualize and compare the wounds. Also, it allows us to provide feedback to patients about how their wound looks initially and show them their progress overtime, which helps with compliance. It helps our patients be willing to turn and comply to interventions. For the population who are at a lifetime risk for PI's, this visualization helps them to see the consequences of noncompliance with preventative measures. The nursing staff have embraced this new process as they see it as something that has benefited our patient population.