The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

REDUCTION OF ORAL PRESSURE ULCERS FOLLOWING IMPLEMENTATION OF THE HOLLISTER ANCHORFAST ET TUBE SECURING DEVICE™ AND THE B&B MEDICAL UNIVERAL BITE BLOCK™

Christopher Teegardin1, Sunniva Zaratkiewicz2, Joel Ray1; 1Respiratory Care, Harborview Medical Center, University of Washington, Seattle, WA; 2Clinical Nurse Education, Harborview Medical Center, University of Washington, Seattle, WA

BACKGROUND: Prevention of hospital acquired pressure ulcers (HAPU) is an important element of patient care, effecting patient morbidity, treatment cost, and reimbursement issues. The Hollister AnchorFast ET Tube securing device™ - in conjunction with the B&B Medical Universal bite block™ – was introduced at our institution, a level 1 trauma and burn center, in December 2007. By April 2009, they became the standard devices and method used to secure oral ET tubes (94% of adult patients). In April 2009, a subjective survey of critical care nurses and respiratory care practitioners compared the AnchorFast to the previous securing devices used here. Over 90% of those surveyed felt the AnchorFast was more maneuverable and provided better access and assessment of the mouth. We hypothesized the use of the AnchorFast would lead to a decrease of HAPUs on the lips, mouth, gums and tongue of orally intubated critical care patients. METHOD: The HAPU Daily Incidence Tracking System and Algorithm used at our institution monitors daily pressure ulcer incidence, providing an improved method of early pressure ulcer identification, tracking, and prevention. Using data collected from this system and a retrospective electronic medical record chart review, the number of pressure ulcers on the lips, mouth, gums, and tongue of orally intubated patients for the ten months prior to introduction of the AnchorFast (Pre-A) was compared to the same data collected for the ten months after the AnchorFast (Post-A) had been established as the standard securing device. RESULTS: In the Pre-A group, 3039 patients were initiated on mechanical ventilation with an undetermined majority supported via an oral ET tube. 21 HAPUs on the lips or in the oral cavity of orally intubated patients was reported. In the Post-A group, 3010 patient were initiated on mechanical ventilation with an undetermined majority supported via an oral ET tube. 2 HAPUs on the lips or in the oral cavity of orally intubated patients was reported during this second interval. CONCLUSION: The reported incidence of HAPUs on the lips and in the oral cavity decreased following introduction of the AnchorFast and Universal Bite Block in our institution. Sponsored Research - None