More than 50 percent of pressure injuries (PIs) occurring in the pediatric and neonatal population are directly related to medical devices.1
Skin integrity alteration in the pediatric population causes physical pain for the child, mental anguish for the parents, and increased cost to healthcare institutions.2
Identified recurrent pediatric impaired skin integrity at a Magnet-designated children’s hospital became the focus for this guideline development initiative. In most healthcare institutions, pediatric treatment and prevention guidelines are adapted from adult practices.2
These practices raise concern for the safety, cost-effectiveness, and clinical efficacy due to the anatomic and physiological differences between the two populations.2
Guideline development and implementation included:
- Assessing the at-risk patient: Braden Q Score, Neonatal Skin Condition Score, and/or Neonatal Abstinence Syndrome (NAS) Score.
- Determining support surface availability and choosing support surface functionality to provide microclimate management with pressure redistribution.
- Other factors included: spinal stability, patient mobility, paralytics/ vasopressors, and respiratory support.
- Based on the assessment and patient weight, provider was guided to select the proper low air loss (LAL) support surface fitted for the appropriate crib, pediatric frame, or cardiac surgical platform.
The LAL guideline provides early identification of the at-risk pediatric population. Early identification and surface initiation mitigates the causative factors.