Case Study: Main Line Health Lankenau Medical Center 2020 HAP Achievement Award

Decreasing Dermal Damage from Endotracheal Tubes in the Intensive Care Unit: A Team Based Approach

Reducing pressure ulcers is a health care priority, as the damage from these injuries can cause pain, increase the risk of infection and scarring, and sometimes require surgical repair. Lakenau Medical Center identified an opportunity to implement changes to decrease pressure ulcers from endotracheal tubes.

Through its project, a multidisciplinary team outlined the factors that contribute to pressure ulcers and implemented a plan to improve outcomes, including:

• Developing a uniform process to reposition endotracheal tube-securing devices at set intervals, including a visual positioning tool that helps ensure staff adjust the breathing tubes on schedule
• Peer-checking and coaching using dermal rounding and audits
• Multidisciplinary case review of any instance of dermal damage resulting from artificial airways
• Education for existing staff and education for new staff as part of orientation
• Developing respiratory team goals to decrease endotracheal tube device-related hospital-acquired pressure ulcers

During the last four years, the hospital has far exceeded its initial goals to reduce pressure ulcers for patients on respiratory devices. This innovative approach to care for patients on breathing tubes has been adopted at other hospitals, as well.

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Topics: Quality Initiatives

Revision Date: 8/1/2020

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