Date of Graduation

Fall 12-17-2021

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Program

MSN project

First Advisor

Susan Mortell DNP, MSN, RN, CNL

Second Advisor

Robin Jackson MSN, MA, RN,OCN, CNL

Abstract

One of the top National Patient Safety Goals by The Joint Commission is to prevent hospital-acquired pressure injuries, which is reiterated by Centers of Medicare and Medicaid as a valuable metric in determining the quality of patient care and safety as well as hospital performance. The Agency for Healthcare Research and Quality reports over 2.5 million patients affected by hospital-acquired pressure injuries per year, costing between $9.1-$11.6 billion per year with the cost of individual patient care ranging from $20,900 to 151,700 per pressure injury (Agency for Healthcare Research and Quality, 2014). Approximately 30% of these cases are related to hospital-acquired pressure ulcers were from medical devices, like the use of extracorporeal membrane oxygenation machines (ECMO) (Apold & Rydrych, 2012). This leads to increased length of stay, increasing mortality rates and added incremental costs for hospitals.

Extracorporeal membrane oxygenation, also known as ECMO, treatment leads to increased risk pressure injuries/ulcers due to cannulas fixation, sedation, positioning, decreased perfusion, and extremity immobilizers on patients which can often lead to fluid shifts and hemodynamic instability in these critically ill patients, which contribute to tissue edema and hypoperfusion, which in turn, leads to increased risk of developing pressure injuries. Despite current evidence-based practice and hospital protocols, there is a need for more in-depth education, training, better equipment as well as updated protocols and greater research for more up-to-date evidence-based practice.

The proposed solution to help further reduce and prevent hospital-acquired pressure injuries is to implement the usage of Fluidized Positioners for customizable pressure redistribution for optimal positioning to decrease pressure injuries and are available for full-body, occiput or sacrum, should the patient be hemodynamically unstable, for continuous lateral rotation therapy. The use of Fluidized Positioners as the proposed solution in lieu of a new skin protocol will help decrease hospital-acquired pressure injuries as well as decrease related hospital costs for hospital-acquired pressure injuries treatment and patient length of stay.

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