Date of Award

Spring 2026

Project Type

Clinical Doctorate

College or School

CHHS

Department

Nursing

Program or Major

DNP

Degree Name

Other

First Advisor

Catherine Colleran

Second Advisor

Amanda Magrum

Abstract

BACKGROUND: Hospital acquired pressure injuries (HAPIs) continue to plague hospitals across the country. HAPIs are an indication of the quality of care delivered by the hospital’s nursing workforce. These injuries are costly to organizations and can lead to increased length of stay (LOS). The development of a HAPI, depending on severity, is a reportable injury and is classified as patient harm. Patients who suffer from HAPIs can experience significant pain and at times, permanent disfigurement. This project’s focus is a community hospital that has seen a steady increase in HAPIs over the last 2 years. During 2025, 28% of the hospital’s 100 HAPIs were attributed to the intensive care unit (ICU). This project aimed to decrease the incidence of HAPIs on the unit by 50%.

METHODS: A literature review was conducted, and articles were critically appraised to identify interventions to help reduce the incidence of HAPIs. A multi-intervention approach was selected, and the Plan-Do-Study-Act (PDSA) method was utilized to implement the project. A pre survey, using a Likert scale, was administered to nursing staff to determine their familiarity with the current hospital policy and the interventions to prevent pressure injuries (PIs). The same survey was administered post intervention. The interventions were implemented over a 4-week period and data were compared to the preceding 4-week period.

INTERVENTIONS: This project had a multi-intervention approach; some interventions were existing and reinforced: repositioning every two hours and the use of support surfaces. Two new interventions were implemented: the implementation of a repositioning team and the implementation of focused skin assessments at shift change by two registered nurses (RNs). RESULTS: The aim of this project was met. Post intervention, the department had a 75% decrease in the incidence of HAPIs. The two-proportion z test was conducted, and the results 3 were not statistically significant, z=1.51, p=0.129. The Mann-Whitney U Test was used to analyze the nursing survey results. The results of the survey for the RNs understanding of the policy was statistically significant; the results for the nurses’ understanding of the interventions was not statistically significantly.

CONCLUSION: Overall, the specific aim of the quality improvement project was met. Known interventions coupled with new interventions showed a positive impact on the reduction of harm for the critical care patient population at this community hospital.

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