A Skin Team Approach to Decrease Pressure Injuries in a Cardiothoracic Intensive Care Unit

PURPOSE: The primary purpose of this quality improvement initiative was to evaluate the effect of a nurse-led skin team (ST) interventions on prevalence of hospital-acquired pressure injuries (HAPIs) of stage 2 and above in our cardiothoracic intensive care unit (CTICU). PARTICIPANTS AND SETTING: Data analysis is based on patients receiving care in our CTICU from 2011 to 2024. The unit is located in the Western US (Los Angeles, CA). APPROACH: A nurse-led ST was established in 2011 to empower and engage clinical nurses in addressing the rising incidence of HAPIs in the CTICU. The team employed the Plan-Do-Study-Act framework to implement both evidence-based and innovative interventions. Project strategies included rounding, monitoring, and educating staff on best practices for pressure injury prevention. OUTCOMES: More than a decade after the team's formation, trend analysis did not demonstrate a significant downward trend in stage 2 and higher HAP prevalence. Nevertheless, our HPAI rates have consistently been below national benchmarks. IMPLICATIONS FOR PRACTICE: The ST approach has proved effective in sustaining a reduction of HAPIs within our facility. The team's interventions remain ongoing, supported by facility leadership and continued commitment to quality care.