Joint Commission Advice for Managing Medical Device-related Pressure Injuries
The Joint Commission (TJC) has issued a new Quick Safety Issue addressing the management of medical device-related pressure injuries. According to TJC, medical device-related pressure injuries account for upwards of 30 percent of all hospital-acquired pressure injuries. As with pressure injuries caused by immobility, medical device-related pressure injuries are frequently found over bony prominences; device-related pressure injuries tend to mirror both the shape and location of a device.
The difference between immobility-related and medical device-related injuries can be challenging to ascertain but any patient with a medical device should be considered at risk for a device-related pressure injury and preventative step should be implemented.
In this Quick Safety Issue, TJC recommends the following safety actions:
- Assessment: Comprehensive skin assessment should include assessing the skin underneath the medical device to identify any early signs of pressure. The pressure injury risk assessment should be standardized and use risk assessment tools/scales. Areas to evaluate include mobility, nutrition, moisture.
- Education: Patient/family education should include an explanation of all medical devices in use, their location, purpose and function. Increasing awareness of the risk of medical device-related pressure injuries is important.
- Positioning: The position of the medical device should, whenever feasible, be routinely redistributed. Medical devices should be removed as soon as possible dependent on the patient’s medical condition.
- Device care: The patient should be provided a device that is the correct size and type for the patient/patient’s condition. Skin should be padded to reduce friction. Manufacturer’s instructions/recommendations for use and care of the device should always be followed.
- Documentation and communication: Standardized communication tools (forms, checklists, etc.) should be used to ensure that patient assessment, interventions and care needs are consistent and effectively communicated to all health care providers and caregivers.
- Teamwork: Ensure an organizational culture that promotes teamwork and communication and promotes pressure injury prevention.
- Continuous monitoring: Conduct surveillance on the incidence and prevalence of medical device-related pressure injuries.
Included with today’s notice is an example policy related to pressure injury prevention.
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