Background The cardiovascular and surgical intensive care units had the highest unit-acquired pressure injury rates at an institution. Patients in these units had multiple risk factors for pressure injuries. Various interventions had been used to minimize pressure injuries, with limited results. Objectives To evaluate the effect of specialty linens on the rate of pressure injuries in high-risk patients. The specialty linen was a synthetic silklike fabric that addressed the microclimate surrounding the patient, with the purpose of minimizing friction, shear, moisture, and heat. Methods The specialty linen was tried on 24 beds in the cardiovascular intensive care unit and 20 beds in the surgical intensive care unit, including sheets, underpads, gowns, and pillow cases. Data obtained from a retrospective review of electronic health records were compared for 9 months before and 10 months after specialty linens were implemented. Results Total unit-acquired pressure injury rates for both units combined declined from 7.7% (n = 166) before to 5.3% (n = 95) after the intervention. The intervention was associated with a significant reduction in posterior (coccyx, sacrum, back, buttock, heel, and spine) pressure injury rates, from 5.2% (n = 113) before to 2.8% (n = 51) after specialty linens were implemented ( P < .001). Conclusion Addressing the microclimate, friction, and shear by using specialty linens reduces the number of posterior pressure injuries. The use of specialty linens in addition to standard techniques for preventing pressure injuries can help prevent pressure injuries from developing in high-risk patients in intensive care units.

Background Implementation of the ruling on the Inpatient Prospective Payment System by the Centers for Medicare and Medicaid has challenged nurses to focus on the prevention of pressure ulcers. Despite years of research, pressure ulcers are still one of the most common complications experienced by patients in health care facilities. Objective To examine the relationship between patients’ characteristics (age, sex, body mass index, history of diabetes, and Braden Scale score at admission) and care characteristics (total operating room time, multiple surgeries, and vasopressor use) and the development of pressure ulcers. Methods In a cohort study, data from the electronic medical records of 3225 surgical patients admitted to a Midwest hospital, from November 2008 to August 2009 were analyzed statistically to determine predictors of pressure ulcers. Results A total of 12% of patients (n = 383) had at least 1 pressure ulcer develop during their hospitalization. According to logistic regression analysis, scores on the Braden Scale at admission ( P < .001), low body mass index ( P < .001), number of vasopressors ( P = .03), multiple surgeries during the admission ( P < .001), total surgery time ( P < .001), and risk for mortality ( P < .001) were significant predictors of pressure ulcers. Conclusion Scores on the Braden Scale at admission can be used to identify patients at increased risk for pressure ulcers. For other high-risk factors, such as low body mass index and long operative procedures, appropriate clinical interventions to manage these conditions can help prevent pressure ulcers.