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Structured Quality Improvement to Reduce Hospital-acquired Pressure Injuries.

Peter B Arnold1, Myrtle D Tate2, LaTrina Holmes-Green3

  • 1Department of Plastic Surgery, University of Mississippi Medical Center.

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|May 20, 2025
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Summary
This summary is machine-generated.

A quality improvement project successfully reduced hospital-acquired pressure injuries (HAPIs) by implementing structured prevention strategies. This initiative achieved significant reductions, comparable to other hospital-acquired conditions.

Keywords:
braden risk assessmenthospital-acquired conditionshospital-acquired pressure injuriesquality improvement

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Area of Science:

  • Healthcare Quality Improvement
  • Patient Safety
  • Clinical Nursing

Background:

  • Hospital-acquired pressure injuries (HAPIs) represent a significant burden on patient care, increasing morbidity and healthcare costs.
  • HAPIs have historically received less focus than other hospital-acquired conditions (HACs) like central line-associated bloodstream infections (CLABSIs) and venous thromboembolism (VTE).
  • Effective prevention strategies used for other HACs can be adapted to reduce HAPIs.

Purpose of the Study:

  • To implement and evaluate a quality improvement (QI) project aimed at significantly reducing the incidence of HAPIs.
  • To achieve a 50% reduction in HAPIs over an 18-month period through structured team-based interventions.
  • To decrease HAPI rates below the national average by enhancing risk assessment and early preventive measures.

Main Methods:

  • A Wound Oversight Committee developed a QI program focused on risk assessment and early intervention for HAPIs.
  • The project included patients admitted to an academic medical center between 2021 and 2023.
  • Key interventions involved implementing a two-person skin assessment within 4 hours of admission and standardizing data collection for public reporting.

Main Results:

  • Two-person skin assessments improved from 20% to over 80% within 18 months, enabling timely preventative actions.
  • HAPI incidence decreased from 14 to 7 cases per month.
  • The standardized HAPI rate dropped from 1.87 per 1000 eligible discharges (2017-2019) to 0.40 (2020-2022), a statistically significant reduction (P<0.05).

Conclusions:

  • A structured QI program incorporating evidence-based HAC reduction strategies, risk assessment, and timely prevention is effective in reducing HAPIs.
  • The observed improvements in HAPI rates are comparable to those achieved for CLABSIs and VTEs.
  • This initiative demonstrates the feasibility and success of applying systematic QI methods to address HAPIs in an academic medical center setting.