Pressure Ulcers in the ICU Setting: Quality Improvement Project

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Clinical Issue

For inpatients, pressure ulcers (PU) remain among the most common health issues and, at the same time, a source of an increased health threat due to the possible complications that pressure ulcers may entail. According to Mondragon and Zito (2020), PU affect 5% to 15% of inpatients in the U.S. alone. Moreover, Díaz-Caro et al. (2020) state that 95% of pressure ulcer cases are preventable, yet the lack of patient-nurse communication, as well as appropriate guidelines and training for nurses, lead to the rapid progression of PU, as well as comorbid issues. Since most PU occur as a nosocomial condition, it is critical to introduce a program allowing nurses to encompass the existing conventions and nuances causing skin damage and the resulting PU development so that the nursing staff could address the problem before it grows out of proportions.

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Table 1. SWOT

  • Opportunity to upgrade the quality of care by improving the existing guidelines for nurses;
  • Locating additional causes of PU development, thus introducing new strategies for PU management and prevention.
  • Lack of tools for motivating nurses;
  • Absence of a coherent guide for PU management in the hospital context.
  • Minimizing the threat of hospital PU development;
  • Improving patient-nurse communication;
  • Understanding the nature of PU as a nosocomial issue better.
  • Failure to identify the causes of PU development in the hospital setting;
  • Failure to meet the needs of patients with PU or patients exposed to PU development;
  • Reluctance to change and refusal to accept training among nurses (Mwakanyanga et al., 2018).

SWOT Analysis

The proposed project represents quite a number of opportunities. Specifically, as the SWOT analysis below indicates, the project will help to raise awareness about the nuanced situations that may lead to PU development. Due to the focus on regular communication with patients and the promotion of building a patient-specific, culture-competence-based approach, the suggested change is expected to shed light on a range of previously unnoticed factors of PU development. In addition, the suggested method enhances nurse-patient communication, while promoting the education of both (Cramer et al., 2019). However, reluctance and resistance to change among nurses represents a major threat. To avoid the described risk, the creation of an incentive-driven approach will be needed. Namely, nurses should be encouraged to participate with the help of financial incentives and training options.

Action Plan for Quality Improvement

Given the results of the SWOT analysis performed above, the further course of action needs to be centered on the development of a new set of guidelines for nurses to address the issue of PU development among inpatients. Afterward, nurses will be introduced to the guidelines and offered a training course for building the necessary skillset, which will include communication with patients. As the nursing staff develops the required skills, they will shift to a new paradigm of managing inpatients’ needs for PU prevention (Khojastehfar et al., 2019). Moreover, a team of nurses will be created to educate patients about the signs and symptoms of PU development so that they could communicate an emergent problem to a nurse. To control the implemented change, reports concerning patients’ well-being and, particularly, their exposure to PU, will have to be submitted regularly. Once the described strategy is in place, PU are expected to be observed more rarely in inpatients. Furthermore, the levels of patient education and nurse competence, including cultural one, are expected to increase.


Cramer, E. M., Seneviratne, M. G., Sharifi, H., Ozturk, A., & Hernandez-Boussard, T. (2019). Predicting the incidence of pressure ulcers in the intensive care unit using machine learning. eGEMs, 7(1), 49. Web.

Khojastehfar, S. H., Najafi Ghezeljeh, T., & Haghani, S. H. (2019). Knowledge and attitude of intensive care nurses regarding the prevention of pressure ulcer. Iran Journal of Nursing, 31(116), 5-17.

Mondragon, N., & Zito, P. M. (2020). Pressure injury. StatPearls.Web.

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Mwakanyanga, E. T., Masika, G. M., & Tarimo, E. A. (2018). Intensive care nurses’ knowledge and practice on endotracheal suctioning of the intubated patient: A quantitative cross-sectional observational study. PloS One, 13(8), 1-13. Web.

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NursingBird. (2022, June 29). Pressure Ulcers in the ICU Setting: Quality Improvement Project. Retrieved from


NursingBird. (2022, June 29). Pressure Ulcers in the ICU Setting: Quality Improvement Project.

Work Cited

"Pressure Ulcers in the ICU Setting: Quality Improvement Project." NursingBird, 29 June 2022,


NursingBird. (2022) 'Pressure Ulcers in the ICU Setting: Quality Improvement Project'. 29 June.


NursingBird. 2022. "Pressure Ulcers in the ICU Setting: Quality Improvement Project." June 29, 2022.

1. NursingBird. "Pressure Ulcers in the ICU Setting: Quality Improvement Project." June 29, 2022.


NursingBird. "Pressure Ulcers in the ICU Setting: Quality Improvement Project." June 29, 2022.