Self-Proning Kits to Reduce Hospital-Acquired Pressure Injuries in Self-Proning Covid-19 Patients

Introduction: In July 2021, there was an increase in hospital-acquired pressure injuries (HAPI) on patients self-proning with Covid-19. Patients with Covid-19 had to self-prone themselves to improve their breathing and oxygen saturation for multiple hours a day.

The purpose is to reduce the number of HAPI by developing a self-proning kit for patients who self-prone. Self-proning patients developed HAPI’s without pressure injury (PI) prevention measures.

Nurses and respiratory therapists (RT) lack knowledge on preventing PI for the patients who were self-proning. Before implementing self-proning kits for patients with Covid-19, the HAPI rate for July 2021 was 0.48 per 1,000 patient days. Methods Physicians, nurses, respiratory therapists, and wound care collaborated to assess best practices and products for prone patients.

The development of self-proning kits included silicone foam dressings, static air cushions, breathable moisture-wicking foam, and a head positioner. Wound care and nursing collaborated to make grab-and-go kits for staff to give to self-proning patients. Healthcare providers educated patients on the self-proning kit and assisted with application and use of the kits. The goal was early recognition of self-proning patients and implementation of the kit to reduce the number of HAPI. The interventions took place in August 2021. An education plan included in-services, educational flyers, and product guides to physicians, nursing, respiratory therapist, and wound care on contents and use of the kits. A cart in the supply room with pre-made kits and staff awareness on the importance of adopting and integrating self-proning kits reduced the number of HAPI in Covid-19 patients.

Results: In August 2021, the HAPI rate decreased to zero, and there has not been a HAPI since the development and implementation of self-proning kits in patients with Covid-19.

Discussion: Using self-proning kits as soon as the patient self-prones reduces the number of Covid-19 patients who develop a HAPI. The kits were implemented on one hospital unit and are utilized in multiple units across the organization with the increased knowledge of prevention measures for patient who self-prone.

After the implementation the HAPI rate decreased from 0.48 in July 2021 to zero since August 2021.