Impact of a quality improvement model to reduce pressure injury and skin integrity incidences in the operating theatre.

Abstract

Hospital-acquired pressure injuries (HAPIs) are localised damage to the skin resulting from pressure either alone or in combination with shear and microclimate. These injuries have a significant impact on patients' well-being and healthcare systems. Prolonged surgery significantly increases the risk of developing HAPIs. The adoption of preventive measures in the operating theatre (OT) can reduce the incidence of HAPIs in this context. This report presents the maintenance of a quality improvement project for HAPI prevention in the OT from 2019 to 2023 and evaluates the impact of the preventive measures on reducing HAPI and overall skin integrity incidents.A retrospective data analysis (from 2016-2017) was conducted to gather baseline information on all skin injuries particularly HAPIs reported in the OT. Upon completion of a needs analysis, a phased improvement project was implemented in 2018 and maintained until 2023. Comparative data from 2016 to Q1 2018 (preimplementation) and Q2 2018 to Q4 2023 (postimplementation) were analysed.A reduction in HAPI and skin integrity incident rate was observed over time (from 1.58 in 2016 to 0.13 in 2023). No pressure injury incidences were reported in 2021 and 2022. Other skin integrity events showed a significant reduction of 38.5%, following the start of this initiative, with steady numbers until 2019 (39 other skin integrity events in 2016 reduced to 24 events in 2018). A major reduction of 82.6% was observed in 2020, with a reduction from 23 other skin integrity events in 2019 to four in 2020, which was sustained as minimal incidents until 2023.The quality improvement project was effective in reducing HAPI in the OT, which was sustained in the following years, resulting in a reduction of global skin integrity issues due to staff awareness, continuous evaluation and implementation of corrective actions.