An Un-hapi PICU - Therapy Involvement in Decreasing Healthcare Acquired Pressure Injuries

Research Objectives: To demonstrate the benefits of occupational (OT) and physical therapy’s (PT) involvement with healthcare acquired pressure injury (HAPI) reduction for pediatric patients in intensive care units.

Design: This poster is based on a quality improvement project.

Setting: A pediatric intensive care unit in a free standing, academic-affiliated healthcare system in the Southern United States.

Participants: All patients admitted to the pediatric intensive care units between January 2021 and December 2023.

Interventions: A guideline was developed by a multidisciplinary team that defined “high risk” and “unstable” patients, specified hemodynamic parameters around repositioning, and provided detailed written and visual instruction for repositioning and turning techniques. Occupational and physical therapists provided hands on demonstrations to ICU nurses over a series of skills days. An educational video was then produced and disseminated throughout the hospital.

Main Outcome Measures: HAPI rate per 1,000 patient days with a goal of < 2.0 documented occurrences.

Results: The annual rate of HAPI decreased from an average of 3.44 occurrences in 2021 to 2.33 in 2022 and to .82 in 2023. Notable decreases in HAPI rates occurred with therapy provided education in January of 2022 and again with the implementation of the Positioning Guideline and production of the instructional video.

Conclusions: The results of this quality improvement project demonstrated the importance of a multi-disciplinary approach to the prevention of healthcare acquired pressure injuries, specifically, the benefit of participation by OT and PT in the development and implementation of positioning guidelines and involvement in the initial and ongoing training of nursing staff.

Author(s) Disclosures: None