2.50
Hdl Handle:
http://hdl.handle.net/10755/157026
Category:
Abstract
Type:
Presentation
Title:
Pucker Up! How to Prevent Lip Pressure Ulcers From Endotracheal Tubes
Author(s):
Oakes, Amanda
Author Details:
Amanda Oakes, Lehigh Valley Health Network, Allentown, Pennsylvania, USA, email: amanda.oakes@lvh.com
Abstract:
PURPOSE: The staff on an ICU in an academic community Magnet hospital noted an increase in pressure ulcers resulting from endotracheal (ET) tube placement. A quality improvement team (QIT) consisting of ICU staff nurses, respiratory therapists, and wound therapists identified possible causes for the increased number of lip ulcers, inclusive of Braden score, number of days on ventilator, nutritional status, use of vasopressors, and fluid balance. DESCRIPTION: The root cause analysis revealed one commonality among the cases of lip ulcers: the taping of the ET tube on the patient's face. The QIT proposed changing the tape holding the ET tube every 24 hours instead of every 48 hours, but this strategy did not produce a reduction in lip ulcers. Collaborative meetings continued and a subsequent suggestion from the literature was to trial a commercially available ET tube holder; this device uses 2 adhesive patches on the patient's cheeks to support a bridge across the upper lip holding the ET tube. Additional actions included repositioning the ET tube and lip inspection every 4 hours, accompanied by required electronic documentation of the actions. EVALUATION/OUTCOMES:After 6 months, no lip ulcers occurred on any patients in the ICU for whom the new ET tube holder was used. This dramatic result prompted implementation of the new ET tube holder throughout the network. The added cost associated with the new holder was taken into careful consideration, as it was a significant increase. To be cost-effective, the ET tube holder is used for patients receiving mechanical ventilation for 24 or more hours and is changed every 3 days or as needed.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866
Conference Date:
2010
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titlePucker Up! How to Prevent Lip Pressure Ulcers From Endotracheal Tubesen_GB
dc.contributor.authorOakes, Amandaen_GB
dc.author.detailsAmanda Oakes, Lehigh Valley Health Network, Allentown, Pennsylvania, USA, email: amanda.oakes@lvh.comen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157026-
dc.description.abstractPURPOSE: The staff on an ICU in an academic community Magnet hospital noted an increase in pressure ulcers resulting from endotracheal (ET) tube placement. A quality improvement team (QIT) consisting of ICU staff nurses, respiratory therapists, and wound therapists identified possible causes for the increased number of lip ulcers, inclusive of Braden score, number of days on ventilator, nutritional status, use of vasopressors, and fluid balance. DESCRIPTION: The root cause analysis revealed one commonality among the cases of lip ulcers: the taping of the ET tube on the patient's face. The QIT proposed changing the tape holding the ET tube every 24 hours instead of every 48 hours, but this strategy did not produce a reduction in lip ulcers. Collaborative meetings continued and a subsequent suggestion from the literature was to trial a commercially available ET tube holder; this device uses 2 adhesive patches on the patient's cheeks to support a bridge across the upper lip holding the ET tube. Additional actions included repositioning the ET tube and lip inspection every 4 hours, accompanied by required electronic documentation of the actions. EVALUATION/OUTCOMES:After 6 months, no lip ulcers occurred on any patients in the ICU for whom the new ET tube holder was used. This dramatic result prompted implementation of the new ET tube holder throughout the network. The added cost associated with the new holder was taken into careful consideration, as it was a significant increase. To be cost-effective, the ET tube holder is used for patients receiving mechanical ventilation for 24 or more hours and is changed every 3 days or as needed.en_GB
dc.date.available2011-10-26T19:21:21Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:21:21Z-
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.conference.date2010en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationWashington, D.C., USAen_GB
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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