Date of Conferral

2017

Degree

Ph.D.

School

Health Services

Advisor

Cheryl Anderson

Abstract

Hospitalized children are vulnerable to pressure injuries. Multiple methods are available to decrease pressure injuries. One specific method is the pediatric pressure injury prevention bundle, which includes device rotation, moisture management, positioning, skin assessment, and support surface management. Although this prevention bundle is available nationwide, it is not known if this type of bundled methodology helps decrease pressure injuries in hospitalized children. Secondary data regarding nursing interventions implemented as a bundle and pressure injury rates from a large pediatric hospital consortium were used to address this gap in the literature. The research questions explored the impact of the pressure injury prevention bundle on pressure injury rates over time and further dissected the data to determine the significance of each intervention in the treatment bundle. Benoit and Mion's model for performance improvement along with the continuous quality improvement model used by the hospital consortium guided the study. The secondary data sample included 102 children's hospitals participating in the national initiative Solutions for Patient Safety. Pearson correlation statistics revealed a significant inverse relationship between nursing interventions and pressure injury rates for hospitalized children. The findings indicated a 57% reduction in rates of pressure injuries over 5 years with nursing participation in implementing the pediatric pressure injury prevention bundle. The impact of any one intervention over the bundle was inconclusive. Positive social change is seen in the ability to decrease pressure injuries in hospitalized children by nurses' implementation of a pediatric pressure injury prevention bundles.

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