Take a Bite out of Hospital-acquired Pressure Injuries with Bite-sized Microlearning for Cardiothoracic Nurses

Introduction: Cardiothoracic acute care patients are at an increased risk for deep tissue injury (DTI) development due to prolonged surgery times, poor perfusion, hemodynamic instability, altered nutritional sta- tus, and co-morbidities. The nursing staff’s knowledge of pressure injury (PI) identification and prevention is essential to reducing the incidence of hospital-acquired DTIs in this patient population. Daily rounding by the wound care nurse team (WCNT) revealed that PI prevention interventions were inconsistently utilized, and that the nursing staff frequently failed to identify DTIs on patients with darker pigmented skin. The purpose was to identify three learning opportunities that our cardiothoracic nurses had regarding PI identification and prevention and to provide micro-learning experiences to increase DTI identification and nurses’ knowledge of evidence-based interventions. Methods: The WCNT conducted pre- and post-intervention surveys following a “1-2-3 Pressure Injury Free” micro-learning approach in which we focused on bite-sized learning opportunities. Learning opportunities in- cluded: (1) In-person vendor fair and the creation of a virtual PI prevention library of the vendors demonstrating their products. (2) Two PI prevention influences (WCNT) to round on at-risk patients and provide guidance on PI identification and interventions. The activities included daily at-risk Braden score checks, PI Tip Tuesdays to highlight the intervention of the week. and QR-code linked videos to PI prevention. (3) Skin champion team to promote PI interventions during their huddles and skin rounds. Interactive road shows included: PI Jeopardy, Wheel of PI preventions, Brownies for Braden Scores, and Staging PIs with Fruit and Berries. Results: For identification of DTIs on darker pigmented skin, our results remained at 67% to 68%. For the definition of a stage 1 PI, our re- sults went from 50% to 54%. For frequency of patient repositioning when in the recliner, our results increased from 45% to 71%. Discussion: While our micro-learning educational offerings modestly increased staff awareness on PI staging, they did significantly increase nurses understanding that patients need to be repositioned more frequently when up in the recliner. On-going work remains with the con- tinued use of bite-sized, interactive educational offerings with post-inter- ventions surveys planned for 4-months and 6-months. EBP-009 (RPT-002) Reducing Endotracheal Tube Securement Medical Device-related Pressure Injuries in Critical Care Through Multidisciplinary Approach Marissa A. Hudler, MSN, RN, WCC, CFCN, OMS; Dona Crumpler, BAT, RRT – Respiratory coordinator, respiratory therapy; Wenna Hershey Alojado, BSN, RN – wound care nurse, wound care, Baylor scott and white health Introduction: Medical device-related pressure injuries (MDRPIs) caused by endotracheal tube (ETT) securement devices are a significant concern in critical care, leading to patient discomfort, prolonged hospital stays, and increased healthcare costs. In July and August 2024, the MDRPI rate was 0.40% per 1,000 patient days, highlighting the need for targeted interventions to reduce these injuries. Methods: Multidisciplinary team collaborated with respiratory ther- apy in August 2024 to evaluate current practices, securement devices, and care gaps. Key issues identified included improper adherence of securement devices, slippage causing friction injuries, poor fit for diverse patient anatomies, and improper removal techniques contributing to skin trauma. In September 2024, a multidisciplinary intervention was launched. This included tailored education from vendor on device application and removal, updated protocols emphasizing patient-spe- cific securement practices, and regular audits to ensure compliance and address ongoing challenges. Results: Before the intervention, securement devices frequently slid down the face, causing friction injuries, and did not adequately fit pediat- ric or bariatric patients. Following the intervention, MDRPI rates dropped to zero in September, October, and November 2024, representing a significant improvement. Ongoing audits confirmed consistent adherence to updated practices and competency in securement practices by the mul- tidisciplinary team. Discussion: This initiative highlights the value of a multidisciplinary approach in addressing MDRPIs associated with ETT securement devices. Collaboration between the multidisciplinary team, coupled with targeted education and competency-based training, resulted in a measurable reduction in MDRPIs. A proactive, patient-centered strategy that integrates multidisciplinary collaboration, education, and regular compliance monitoring can effectively reduce MDRPIs in critical care settings. The sustained reduction in MDRP- Is underscores the importance of collaboration, targeted interventions, and ongoing education in improving patient outcomes and care quality.