Evaluation of a fluidised positioner to reduce occipital pressure injuries in intensive care patients: A pilot study

Int Wound J. 2019 Apr;16(2):424-432. doi: 10.1111/iwj.13051. Epub 2018 Dec 17.

Abstract

This pilot study aimed to evaluate the clinical efficacy and feasibility of a fluidised positioning device to reduce occipital pressure injuries (PIs). A post-test design with a historical control group was used in a 54-bed intensive care unit between September 2017 and August 2018. Patients who were receiving either extracorporeal membrane oxygenation, were mechanically ventilated, or had raised intracranial pressure (≥20) were recruited. The intervention consisted of a fluidised positioning device under the patient's head, and a skin assessment every 8 h. Outcome measures included the occurrence of occipital PIs and registered nurses (RNs)' perspectives of the intervention. Data collected from patients in the intervention group were compared with data obtained from the historical control group between May 2016 and April 2017. Sixty-four patients were recruited in the intervention phase and 63 were in the historical control group. Results showed a statistically significant reduction in occipital PIs by 87.7% (16/63; 25.4% historical control vs 2/64; 3.13% interventional group). Bedside RNs provided positive evaluation of the fluidised positioning device. The findings demonstrate that the fluidised positioning device is a feasible and effective intervention in reducing the risk of occipital PIs in intensive care patients, which merits the continuation of use and further evaluation through a larger-scale study.

Keywords: critical care; device; occiput; positioner; pressure injury prevention.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Australia
  • Critical Care / methods*
  • Equipment Design / standards*
  • Female
  • Head*
  • Humans
  • Male
  • Middle Aged
  • Occipital Lobe / injuries*
  • Patient Positioning / instrumentation*
  • Patient Positioning / standards*
  • Pilot Projects
  • Pressure Ulcer / prevention & control*
  • Stress, Mechanical