Large-Scale Coordinated Prevention of Pressure Injuries in Public Hospitals: Review of a Statewide Hospital-Acquired...

The purpose of this retrospective study was to evaluate the effect of an organization-level, hospital-acquired pressure injury (HAPI) prevention program over a 15-year period. A secondary aim was to summarize the program priority areas, and the resources used to inform and support its delivery.

Retrospective statewide audit.

Sixteen hospital and health services in Queensland, Australia, provided HAPI-related indicator data between 2013 and 2018, involving up to 4245 hospital inpatients each year.

A retrospective evaluation was undertaken using statewide audit data from up to 121 hospitals collected annually between 2003 and 2018. Outcomes of interest were HAPI prevalence and related indicators (n = 6). Priority focus areas of the program and supporting resources were extracted from annual reports, strategic plans, meeting minutes, and an internal publishing database.

Following commencement of the program in 2006, HAPI prevalence decreased from 14% to 3% in 2018, with corresponding improvements in all 6 related indicators. Program focus areas and supporting resources were multifaceted and evidence based, targeting organizational policy, guidelines, equipment use, procurement, clinical tools, and education. A range of data sources informed the annual program focus including audit, evaluation, and pressure injury clinical incident data.

The formation of a statewide HAPI prevention program coincided with a sizeable reduction in HAPI prevalence. This evaluation demonstrates that large-scale quality improvement programs to reduce HAPIs can be effective and sustainable.