Implementing a decision-support tool to prevent community acquired pressure injuries in spinal cord injury (SCI) in the SCI clinic: A pilot study
Purpose
To assess acceptability, usability and satisfaction of a decision support tool (called CAPP-FIT) used in SCI clinic and effect on community-acquired pressure injuries (CAPrI) incidence in Veterans with SCI.
Background and significance
Individuals living with SCI experience pressure injuries (PrIs) frequently with devastating impact on quality of life and cost. The majority of PrIs occur in the community, but there is little guidance in CAPrI prevention.
Theoretical/Conceptual framework
Pilot of a tool developed using qualitative and Delphi methods
Method
The CAPP-FIT is used prior to an established SCI clinic visit and includes: 1) a Veteran survey to identify risks, actions, and resources needed to prevent CAPrIs (on iPad app), and 2) a companion Provider Report immediately available listing Veteran responses to survey items identifying CAPrI risks with recommended evidence-based provider actions. The CAPP-FIT was piloted at one SCI Clinic. Veteran-identified risks were summarized. Chart review revealed use of evidence-based provider actions to address identified risks. Veteran satisfaction with the CAPP-FIT was measured with the Mobile App Rating Scale. Provider focus group assessed acceptability, feasibility, and satisfaction. CAPrI incidence was compared to a propensity match. Root cause analysis described cause of CAPrI incidence in participants.
Results
112 Veterans with SCI and 7 providers participated in the pilot. The most common risks identified at the initial CAPP-FIT implementation were acute illness, mobility/activity, and substance issue. The CAPP-FIT stimulated provider interventions for most Veteran-identified risks. Most Veteran participants and providers were satisfied with the CAPP-FIT and agreed that it promoted Veteran-provider communication. CAPrI incidence decreased. Root cause analysis revealed causes of CAPrI incidence.
Conclusions
CAPP-FIT-use in the SCI clinic can prevent CAPrIs.
Implementing a decision-support tool to prevent community acquired pressure injuries in spinal cord injury (SCI) in the SCI clinic: A pilot study