Authors (including presenting author) :
Yeung MF (1), Hui CM (1) Kwok MK (2), Wong KW (1), Wong NM (1), Pang LH (1), Yeung SK (1), Lo SO (1), Chan YY (1), Chun HY (1), Lee SS (1)
Affiliation :
(1) Kowloon East Cluster, Department of Intensive Care
(2) Department of Medical Specialties Services of Tseung Kwan O Hospital (TKOH)
Introduction :
Research found that up to 83% of patients might develop Pressure Injuries (PIs) within five days of hospitalization (Bansal et al, 2005). In 2023, the incidence rate of sacral and coccyx area PIs during 4-6 days in TKOH Intensive Care Unit (ICU) was increased from 0 case in 2022 to 7 cases in 2023. Therefore, TKOH ICU implemented a skin care enhancement program which using PIs risk assessment by Braden Scale and a biomarker scanning tool called Subepidermal Moisture (SEM) for predicting the risk of PIs development, then different skin care strategies were applied according to the data collected from Braden Scale and SEM.
Objectives :
1. To decrease the prevalence rate of sacral and coccyx area PIs in TKOH ICU within 5 days (Length of stay in ICU)
2. To enhance nurses’ compliance rate on early PIs risk assessment within duty shift after ICU admission
Methodology :
1. 4 training sessions on nursing skin care strategies with application of different skin care products according to PIs risk assessment with Braden Scale and SEM to all TKOH ICU nurses.
2. PIs risk assessment and nursing care strategies:
i. Low Risk (Braden Scale >18): Standard skin care
ii. Medium Risk (Braden Scale ≤ 18 and SEM < 0.6): Advanced skin care, SEM on Day 5 of ICU admission
iii. High Risk (Braden Scale ≤ 18 and SEM > 0.6): Skin protective strategy, SEM on Day 5 of ICU admission
Result & Outcome :
The skin care enhancement program started from 04 May 2024, there were 117 patients recruited till 3 August 2024, 59 patients had “Medium” PI risk, and 48 patients had “High rate” PI risk. The mean SEM score on ICU admission was 0.777 (95% CI: 0.890, 0.664), comparing with 0.652 (95% CI: 0.754, 0.550) on Day 5, there was a reduction of SEM score (0.125), and there was no incidence of PIs during this period. Nurses’ compliance on PIs risk assessment by Braden Scale and SEM was 95%.
