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2021 Annual Conference

du 10 au 13 March 2021

Protect the Nares: Reducing Nares Acquired Pressure Injuries in Adults

jeudi 11 mars 2021 à 12:10–12:40 EST add to calendar
Posters
Topic of Interest
CNS Improving Outcomes
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. 

Primary Presenters

Barbara Gulczynski, DNP, APRN-BC, CCRN-CMC, Rush University Medical Center

Co-Authors

Shirley Ambutas, DNP, APRN-BC, CCRN-K, CCNS, Rush University Medical Center
Lisa Boudreau, MSN, RN, CWOCN, Rush University Medical Center
Lillian Hall, MSN, APRN, ACCNS-AG, CCRN, Rush University Medical Center
Emily Sermersheim, DNP, MPH, RN-BC, Rush University Medical Center
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