Enhancing Critical Care Patient Safety: Evaluating the Impact of an Air-Assisted Pressure Offloading Device on Sacral Area Pressure Injuries.

Pressure Injuries (PIs) are one of the most common and costly complications occurring in US Hospitals. A large health system has faced challenges in meeting the benchmark standards for hospital-acquired pressure injuries (HAPIs) set by the National Database of Nursing Quality Indicators (NDNQI) in five of the six critical care units. The percentage of HAPIs in 2023 Q2 was more than double the mean percentage of NDNQI of HAPIs for teaching institutions. The estimated cost for treating HAPIs in 2022 was over $9.5 million. This is a large financial cost but the human cost of developing PIs can lead to many complications such as osteomyelitis, disability and even death. Methods: A quality improvement (QI) project was initiated in three of the six critical care units in the last quarter of 2023. Patients who met criteria for use were placed on an air-assisted repositioning device in order to decrease the risk of developing a HAPI. The device was designed to improve the ease of turning patients and with the accompanying wedges helped maintain a 30 degree turn in order to offload the sacral area. Results: A Prevalon Criteria for Use document was created. We conducted a comparative analysis of HAPI rates per 1000 patient days for each quarter of 2023 and compared them to the HAPI rates for Q4 after implementation of the QI project. Q4 HAPI rates decreased 9.5% from Q3 HAPI rates and decreased 21.43% compared to the average of the first three quarters of 2023. 184 patients were estimated to have been placed on the device. Four patients developed a HAPI on the device and nine patients developed a HAPI after discontinuation of device. The device did not lead to improvements in HAPI progression or staging. Conclusions: The device did not meet our goal of a 30% reduction in HAPIs in the three critical care units, but it led to appreciable reductions in HAPIs. The project showed that more research and time is needed to truly determine the effectiveness of the device to significantly reduce HAPIs.