ArticlePediatrics2013
A quality-improvement collaborative project to reduce pressure ulcers in PICUs.
Article in Pediatrics, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 87 citations in OpenAlex.
- Infant skin maturation: Preliminary outcomes for color and biomechanical properties.Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI) · 2017Trial
- A multicenter, randomized, controlled trial of osteopathic manipulative treatment on preterms.PloS one · 2015Trial
- Formative qualitative evaluation of an improvement programme delivered in an English hospital trust to reduce harm from pressure ulcers.BMJ open quality · 2024Article
- Global variation in skin injures and skincare practices in extremely preterm infants.World journal of pediatrics : WJP · 2023Article
- The biomechanical efficacy of a hydrogel-based dressing in preventing facial medical device-related pressure ulcers.International wound journal · 2022Article
- A scoping review to inform a multi-disciplinary approach for nutrition therapy in critically ill children with pressure injuries.Translational pediatrics · 2021Article
- A Comparison of the Braden Q and the Braden QD Scale to Assess Pediatric Risk for Pressure Injuries During Noninvasive Ventilation.Respiratory care · 2021Article
- Dressings cut to shape alleviate facial tissue loads while using an oxygen mask.International wound journal · 2019Article
- Reducing pressure ulcers across multiple care settings using a collaborative approach.BMJ open quality · 2019Article
- Instruments for the care of pressure injury in pediatrics and hebiatrics: an integrative review of the literature.Revista latino-americana de enfermagem · 2018Review
- The Unfavorable Alliance of Pain and Poor Sleep in Children with Life-Limiting Conditions and Severe Psychomotor Impairment.Children (Basel, Switzerland) · 2018Article
- Pressure Injuries in Medically Complex Children: A Review.Children (Basel, Switzerland) · 2017Review
- Second Annual Meeting of the International Society of Pediatric Wound Care.Advances in wound care · 2015Article
- Prevention of Pressure Ulcers in a Pediatric Cardiac Intensive Care Unit.Pediatric quality & safetyArticle
- Impact of a Pressure Injury Prevention Bundle in the Solutions for Patient Safety Network.Pediatric quality & safetyArticle
- Set of Quality Indicators of Pediatric Intensive Care in Spain: Delphi Method Selection.Pediatric quality & safetyArticle
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
BACKGROUND AND
objectivePediatric patients are at risk for developing pressure ulcers (PUs) and associated pain, infection risk, and prolonged hospitalization. Stage III and IV ulcers are serious, reportable events. The objective of this study was to develop and implement a quality-improvement (QI) intervention to reduce PUs by 50% in our ICUs.
methodsWe established a QI collaborative leadership team, measured PU rates during an initial period of rapid-cycle tests of change, developed a QI bundle, and evaluated the PU rates after the QI implementation. The prospective study encompassed 1425 patients over 54 351 patient-days in the PICU and NICU.
resultsThe PU rate in the PICU was 14.3/1000 patient-days during the QI development and 3.7/1000 patient-days after QI implementation (P < .05), achieving the aim of 50% reduction. The PICU rates of stages I, II, and III conventional and device-related PUs decreased after the QI intervention. The PU rate in the NICU did not change significantly over time but remained at a mean of 0.9/1000 patient-days. In the postimplementation period, 3 points were outside the control limits, primarily due to an increase in PUs associated with pulse oximeters and cannulas.
conclusionsThe collaborative QI model was effective at reducing PUs in the PICU. Pediatric patients, particularly neonates, are at risk for device-related ulcers. Heightened awareness, early detection, and identification of strategies to mitigate device-related injury are necessary to further reduce PU rates.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.