Effect of a Team Approach to Pressure Injury Management over 5 Years in a Tertiary Hospital

Abstract

OBJECTIVE The authors' facility established a novel integrated wound care team (IWCT), which included the implementation of a strict treatment algorithm by the patients' attending providers and a specialized wound care team led by a plastic surgeon. Investigators then retrospectively analyzed clinical outcomes of pressure injury (PI) management by the IWCT over 5 years. METHODS The authors performed a retrospective chart review and periodic statistical analysis of the data for all patients with PI referred to the IWCT in the authors' center from May 2015 to April 2019. Data including patients' demographic information, first and last consultation dates, referring department, PI stage, site of PI, and Braden Scale scores were collected and analyzed. RESULTS Patients (N = 15,556) did not differ significantly in age, sex, or Braden Scale score. A preimplementation/postimplementation analysis of PI data before and after establishing the IWCT showed that the incidence of stage 3 or 4 PIs had significantly decreased during the study period (19.1% vs 15.2%, P <.05). Conversely, the incidence of stage 1 PIs significantly increased in the same period (38.0% vs 57.4%, P <.05). The proportion of completely healed PIs also increased, and the median treatment period was significantly shortened (P <.05). CONCLUSIONS Implementation of the IWCT in a tertiary hospital setting led to a significant increase in early-stage PI detection and a decrease in severe PIs.