Protect the Nares: Reducing Nares Acquired Pressure Injuries in Adults
Topic of Interest
Quality Initiatives
Interprofessional Collaboration
Abstract
Purpose:
The purpose of this quality improvement project is to develop an innovative solution to reduce device related nares pressure injuries (NAPIs) in the adult inpatient populations.
Participants and Settings:
Participants include adult inpatients and nursing staff that provided direct patient care in a Midwest Magnet designated 664 bed academic medical center.
Design:
Systematic quality improvement methodologies yield a creative method for preventing nares pressure injuries beyond the recommended securement device. (18 words)
Methods:
A team of clinicians identified the “T” – shaped hydrocolloid protective barrier as a key driver in reducing device related pressure injuries related to a nasogastric or small bore feeding tube. In conjunction with patient assessments and a securement device, the nurse driven NAPI bundle was implemented to reduced pressure on the nares.
Results:
This quality improvement project yielded positive and sustainable results. In FY15, the house wide baseline NAPI incidence rate was 5.6%. In FY16, the Surgical Intensive Care Unit pilot confirmed design effectiveness that yielded a 70% NAPI reduction. In June FY16, the pilot expanded to all adult inpatient units leading to further decline of NAPIs to 3.5%. In FY17, results were further reduced and sustained as the organization exceeded it targets, with incidence rates of 1.6%.
Conclusion:
Success was achieved utilizing the nurse driven NAPI bundle to enhance patient safety. Data reflects adult inpatients with a nasogastric or small bore feeding tube benefit from the innovative “T”-shaped hydrocolloid protective barrier, securement device and additional NAPI bundle components. Significant sustainable results led to a reduction in nares acquired pressure injuries in adult inpatients.