Background: There is a new focus on medical device-related pressure injuries (MDRPI). Endotracheal tubes (ETT) and their fasteners constitute a portion of these injuries and may lessen the quality of life and function of the critically ill patients who suffer from them. Local Problem The purpose of this quality improvement project was to determine if a bundle of interventions in patients with ETT and their fasteners may lessen the rate of mechanical device-related pressure injuries. Methods/Interventions: The project consisted of pre-and post-intervention surveys of nursing comfort with ETT movement/assessments, implementation of a standardized turn clock to have all ETTs in the same location and moved every 2-3 hours, and job aids related to the assessment and documentation of ETT movement. Results: The project's pre-implementation survey revealed that some nurses were uncomfortable with manipulating the ETT tube and may prevent them from moving the ETT. The post-implementation survey demonstrated improved comfort with moving the ETT. While nurses felt they regularly assessments, they acknowledge that do not often chart ETT movement. Documentation audits bore out these claims ⁰́₃ most charts did not include ETT movement or peri⁰́₃oral/mucosal tissue assessments. Of note, in the three months before the project, there were 3 ETT-related pressure injuries, and none during the implementation. Conclusions: This project sought to determine whether a bundle of interventions might lessen the rate of MDRPI associated with ETT and their fasteners. This bundle of interventions may be useful to other healthcare organizations struggling with this subset of pressure injury.
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