Document Type

Final Project

Graduation Date

Spring 5-6-2023

Degree Name

Doctor of Nursing Practice

First Advisor

Janet Cuddigan

Second Advisor

Nancy Meier

Abstract

Objective: The purpose of this pilot feasibility study was to more effectively prevent hospital-acquired pressure injuries in high-risk patients by using infrared thermography and subepidermal moisture scanning to identify early signs of tissue injury from pressure. Methods: Data was collected in the Cardio-Vascular Intensive Care Unit (CVICU) and cardiac medical-surgical care floors at Nebraska Medicine. Inclusion criteria are adults, scheduled for a surgery or procedure(s) predicted to last four or more hours, and planned admission to the ICU afterward. Participants were scanned with FDA-approved infrared thermography (IT) and subepidermal moisture (SEM) scanners before their procedure, two hours post-procedure, and then every 24 hours for a minimum of four additional scans. If results indicated early injury, (i.e., IT of plus or minus 1.2 degrees Celsius above or below surrounding tissue temperature or a SEM delta equal to or greater than 0.6), additional focused pressure injury preventive measures were recommended per institutional protocol and in collaboration with nurses. Results: A total of 23 patients were enrolled. Two surgeries were canceled and one patient withdrew leaving a total of 20 patients with data available for analysis. One operating room related pressure injury (ORPI) developed for an incidence of 5% in an extremely high-risk sample. Conclusions: IT and SEM detected early tissue damage that was not visible to the naked eye. This prompted earlier and more targeted pressure injury prevention strategies than would have been implemented by usual practices of prevention based on Braden subscale scores and population specific risk factors.

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