The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts


Sherry Babic1, Mary Ann Sammon2, Robert L. Chatburn1; 1Respiratory Institute, Cleveland Clinic, Cleveland, OH; 2Nursing, Cleveland Clinic, Cleveland, OH

BACKGROUND Hospitals currently do not receive reimbursement for care directly related to the treatment of institution acquired pressure ulcers. Therefore, more resources are being invested to reduce wound incidence. Respiratory care equipment such as nasal cannulas, noninvasive ventilation masks, and artificial airways often contribute to the incidence of pressure ulcers. However, respiratory therapists receive little or no education regarding skin care assessments. The purpose of this study was to determine if providing education to the respiratory therapy staff might be associated with a decrease in the incidence of respiratory related pressure ulcers. METHODS Staff education was comprised of a slide presentation (30 slides). The presentation was posted online for therapists to view and confirm their participation. The objectives of the presentation were to recognize and explain: the incidence of pressure ulcers from respiratory devices, the stages of pressure ulcers, the risk factors associated with skin breakdown, and strategies for preventing and managing pressure ulcers caused by respiratory devices. In addition we gave in-services to answer staff questions. After training, therapists were explicitly asked to look for and document evidence of pressure ulcers. Daily surveillance of wound occurrence was performed by nursing staff. Average monthly wound incidence was recorded as the total monthly wounds divided by the average daily census, expressed as a percent. The average wound incidence for the 6 months prior to and after training was compared with a t-test, with P < 0.05 indicating significance. RESULTS After education, therapistsÂ’ documentation of pressure ulcers did not increase. The 2011 monthly incidence of respiratory care related wounds is shown in the graph. There was no difference in average monthly incidence of respiratory care related pressure ulcers before and after staff education (mean 1.8% vs 1.5%, P = 0.520). However, the power was low (0.05) due to the small sample size. The graph shows what seems to be a large drop in wound incidence just after initial education (July) and after subsequent sessions (September and December). CONCLUSIONS Providing education to respiratory care staff regarding therapy related pressure ulcers was not associated with a decreased incidence of wounds over a 6 month period. However, it appears that monthly educational efforts might be effective. Sponsored Research - None