Melhoria da qualidade da prevenção de lesão por pressão em uma unidade de terapia intensiva

Abstract

Introduction: Pressure injuries are one of the most frequent adverse events in healthcare environments around the world, with a significant impact on patients and healthcare services. Despite the negative potential, the majority of these injuries are preventable through the provision of quality health services and a focus on prevention. Improvement projects are a strategy for implementing effective and long-lasting pressure injury prevention programs. Objective: To improve the quality of the pressure injury prevention process in an adult Intensive Care Unit (ICU). Method: This is a study with a quantitative approach, quasiexperimental design, before and after type, without a control group, developed through the implementation of a quality improvement project, in an ICU, in the Municipality of Currais Novos, Rio Grande From north. The project was developed following the steps of an improvement cycle. The level of quality of injury prevention was measured before and after interventions, using six quality criteria. The interventions were didactically divided into two strategic lines: changes in records related to assistance in the prevention of pressure injuries and awareness/training of the multidisciplinary team on pressure injury prevention. In the second evaluation, the absolute and relative improvements of each of the criteria were estimated, as well as their statistical significance. Results: The initial quality assessment showed that the level of pressure injury prevention compliance was low, with practically all criteria showing rates below 50%. After the interventions, there was an increase in compliance with almost all criteria, except skin assessment upon admission, which showed a slight decrease. Conclusions: It was possible to improve the quality of the injury prevention process, despite the contextual factors that interacted to make implementation difficult. But the results indicate that there is still room for further improvements, especially in bed repositioning and skin assessment and reassessment. Furthermore, this improvement process needs to be continuous and dynamic.