Hospital-acquired pressure injury prevention: a quality improvement project

The prevention, management and monitoring of pressure injuries (PIs) have become an important quality indicator for healthcare. In an acute care organisation, hospital-acquired pressure injuries (HAPI) remained prevalent, despite the implementation of a structured plan for PI prevention. The gap in practice for January 2021 to March 2021 was a HAPI incidence rate of 6.35% in the acute care unit. The project's purpose was to implement a HAPI prevention bundle and improve nurses' knowledge of prevention measures. The measured outcome was the HAPI incidence rate on the identified unit. This quality improvement project used Lewin's change theory as the framework. The PICOT clinical question was: 'How does implementing a PI prevention bundle and validating the knowledge, skills and attitudes of nurses on a medical surgical/step-down unit result in an improvement in the HAPI rate and improve the knowledge of nurses over eight weeks compared to solely utilising the current PI hospital policy and online PI education tool?' For the eight weeks from October 2021 to November 2021, the pre-implementation HAPI incidence rate was 6.51%. Post-implementation, the HAPI incidence rate decreased by 5.5%, and knowledge scores increased by 13% (average test score pre-implementation was 75.8%). Limitations were nursing shortages due to the COVID-19 pandemic. Recommendations included implementing the intervention bundle and competency assessment in other units over an extended timeframe and with a larger sample of patients.