The Development of Nursing Innovation for Pressure Injury Prevention in Critical Illness Infants

Abstract

Critically ill infants have underdeveloped physical and physiological characteristics, limited mobility, and often require medical devices, which increase their risk of pressure injuries. This study aimed to investigate the challenges and the need for developing a prevention model, design and develop nursing innovations to prevent pressure injuries, compare nurses’ knowledge before and after a workshop, and evaluate the use of these innovations in professional practice. A research and development project was conducted in the neonatal intensive care unit of Phetchabun Hospital from September 2023 to June 2024, comprising three phases: situational analysis, innovation development, and evaluation. Participants included 13 professional nurses and 80 critically ill neonates. Research instruments comprised the nursing innovations, usage and evaluation records, pre–post knowledge assessments, and nurse satisfaction questionnaires. Descriptive statistics were used for general data, Chi-Square for group differences, Fisher’s Exact Test for pressure injury rates before and after innovation use, and paired sample t-test for nurses’ knowledge scores. The findings indicated that critically ill neonates remained at high risk for pressure injuries and lacked concrete preventive innovations. The developed innovations, including a “protective box” and a “nursing practice guideline for pressure injury prevention,” significantly increased nurses’ knowledge (p < 0.001), reduced pressure injury incidence (p = 0.005), and achieved the highest level of nurse satisfaction ( = 4.51, S.D. = 0.34) The study demonstrated that these innovations could reduce pressure injuries, enhance neonatal quality of life and development, establish systematic care approaches, and potentially be scaled to other units and nationwide.