Feasibility, acceptability, and usability of implementing a medical device-related pressure injury algorithm for critically ill patients using non-invasive ventilation.

OBJECTIVES: Describe the feasibility, acceptability, and usability of implementing a nurse-led intervention to prevent medical device-related pressure injury in critical care patients using non-invasive ventilation during hospitalization.

STUDY DESIGN: A quality improvement project, using a descriptive single-arm study design with convenience sampling.

SETTING AND PARTICIPANTS: This study was conducted at a Midwestern medical center with 640 beds (two hospital campuses). After an educational session, the nurse-led algorithm for non-invasive ventilation medical device-related pressure injury prevention was implemented in two critical care nursing units (cardiac medical progressive care and neurotrauma intensive care unit). Nursing staff were full or part-time critical care nurses.

MAIN OUTCOME MEASURES: Feasibility, acceptability, and usability of the non-invasive ventilation medical device-related pressure injury algorithm were measured (bedside rounding and pre/post System Usability Scale).

RESULTS: Thirty-five nurses (52.2 %) completed a pre-educational survey; 8 (11.2 %) completed a post-survey. The total mean pre-survey score was 70.7 (SD ± 13.6) and the post-survey mean score was 71.3(SD ± 19.6). There was a statistically significant increase in the post-survey mean score {Χ2 (1, N = 43) = 43.5, p <.05}, however, the 0.06 increase was not clinically meaningful. Bedside rounding interviews (n = 22) indicated 82 % (n = 18) of the nurses used the algorithm. The SUS tool mean score was 83.3 (10.73) pre-implementation (n = 21); and 85.63 (8.26) post-implementation (n = 5), indicating clinical usability of the algorithm pre- and post-implementation.

CONCLUSION: The feasibility, acceptability, and usability of implementing a medical device-related pressure injury algorithm for critically ill patients using non-invasive ventilation were demonstrated during this study. More nursing research is needed to develop scalable interdisciplinary clinical algorithms to reduce medical device-related pressure injuries in patients using non-invasive ventilation.

IMPLICATIONS FOR CLINICAL PRACTICE: This study focused on the bedside usability of the algorithm in a clinical setting. Implementing this nursing-developed algorithm created an interdisciplinary framework in which nursing assessment may guide clinical care.