Key Drivers in Reducing Hospital-acquired Pressure Injury at a Quaternary Children's Hospital

Area of Science:

• Healthcare Improvement Science
• Patient Safety Research
• Quality Management in Healthcare

Background:

• Hospital-acquired pressure injuries (HAPIs) remained a significant issue, with rates three times the mean for participating children's hospitals.
• Previous implementation of the Solutions for Patient Safety (SPS) HAPI prevention bundle did not yield desired results.
• This necessitated a comprehensive, enterprise-wide initiative to address persistent HAPI rates.

Purpose of the Study:

• To describe a newly designed, organization-wide initiative aimed at reducing hospital-acquired pressure injuries (HAPIs).
• To identify and detail the key drivers implemented within the initiative.
• To report the resulting decrease in the SPS-reportable HAPI rate following the intervention.

Main Methods:

• A hospital-wide HAPI reduction initiative was designed, focusing on three core drivers: standardization, data transparency, and accountability.
• Existing individual unit-based HAPI reduction efforts were paused to implement a unified strategy.
• SPS-reportable HAPI rates per 1,000 patient days were calculated for pre- and post-initiative phases and compared using a t-test.

Main Results:

• The mean SPS-reportable HAPI rate decreased from 0.3489 in the preimplementation phase to 0.0609 in the postimplementation phase.
• This reduction represents a statistically significant decrease (P < 0.00032).
• The initiative achieved an overall HAPI rate reduction of 82.5%.

Conclusions:

• An institutional pause and a re-tooled initiative focusing on standardization, data transparency, and accountability led to a significant reduction in HAPI rates.
• The key drivers of standardization, data transparency, and accountability were critical to the initiative's success.
• The findings demonstrate the effectiveness of a structured, organization-wide approach to reducing hospital-acquired pressure injuries.