Hospital-Acquired Pressure Injuries Flashcards

Flashcards about Hospital-Acquired Pressure Injuries (HAPIs)

Hospital-Acquired Pressure Injuries (HAPIs)

Injuries that begin at the point of contact between soft tissue and a hard surface, often presenting as an inverted cone-shaped wound.

Bony prominences most likely to develop HAPIs

Sacrum, ischial tuberosity, lateral malleolus, trochanter, and calcaneus.

Proper patient care to reduce HAPI occurrence

Regular examination of patient's skin, position changes every two hours, heel elevation, limiting trochanter positioning, using trapeze or draw sheet, pressure reducing devices, prompt washing and drying, minimizing friction and shearing, and ensuring adequate diet and hydration.

Pathophysiology of HAPIs

External pressure that exceeds the patient's cardiovascular capacity, leading to hypoperfusion, tissue ischemia, and necrosis.

Risk factors for HAPIs

Decreased mobility, cognitive decline, sensory perception, fecal or urinary incontinence, integumentary breakdown, decreased mental status, poor nutrition, friction/shear, and tissue ischemia.

Stage I HAPI

Non-blanching erythema of intact skin.

Stage II HAPI

Partial thickness skin loss involving epidermis and/or dermis, presenting as an abrasion, blister, or shallow crater.

Stage III HAPI

Full-thickness skin loss with damage/necrosis of subcutaneous tissue, extending further but not penetrating underlying fascia. Bacterial infection is common.

Stage IV HAPI

Full-thickness skin loss with extensive destruction and necrosis of overlying structures (muscles, bones, tendons). Sinus tracts may be present, along with necrotic tissue and widespread infection.

Techniques for wound debridement

Surgical debridement, hydrotherapy, larval therapy, and topical enzymatic debridement

Wound irrigation

Removing debris and pus, reduces bacteria, loosening devitalized tissue.

Primary Closure

Direct apposition of skin edges of acute surgical or traumatic wounds after preparation with sutures/staples.

Healing by Secondary Intention

Wound is purposefully left open and fills with granulation tissue and eventually epithelization.

Solutions for wound irrigation

Sterile 0.9% sodium chloride and sterile water

Low pressure irrigation

1-2 pounds per square inch or PSI.

High pressure irrigation

Greater than 8 PSI or >8PSI