Date of Award
Summer 2026
Abstract
Background: Hospital-acquired pressure injuries (HAPIs) are a significant quality indicator within the hospital system. HAPIs increase hospitalization, morbidity, and associated healthcare costs. The current evidence suggests that ongoing nursing education can improve pressure injury prevention and help in the early identification.
Local Problem: Nurses within a medical-surgical unit demonstrated a gap in knowledge in the identification of hospital acquired pressure injuries and lack of accuracy when charting skin findings. Thus, contributing to a delay in recognition and treatment of HAPIs.
Methods: This quality improvement project utilized the Plan-Do-Study-Act (PDSA) framework to guide implementation of educational flipbooks. Materials contained standardized wound terminology and their correlating photographs. Pre- and post-intervention surveys were utilized to measure nurses' knowledge, while chart audits were utilized to capture accuracy of charting.
Results: Eight nurses completed the pre-intervention survey while four completed the post-intervention survey. Nurses reported an increase in knowledge across all measured domains. The most improved area was in the utilization of correct wound terminology, which improved by 38.9%. Next, nurses reported an improvement of 22.4% in differentiating pressure injuries from other conditions. Knowledge of pressure injury prevention improved by 12.5% while the recognition of early skin breakdown saw an improvement of 11.8%. To measure objectively, chart audits were performed but inconclusive. Only one HAPI occurred during the project period, leading to a lack of data. Additionally, participation remained low due to staffing shortages, increased workload, and leadership turnover.
Conclusions: The educational flipbooks overall demonstrated a positive improvement in nursing knowledge in pressure injury identification. Though results showed improvement, the sample size was small and there was limited objective outcome data. The project remained low cost, it was easily implemented, required minimal time from nurses, and has potential to be replicated in other units.
Document Type
Capstone
First Advisor
Elizabeth Evans
Second Advisor
Pamela Kallmerten
College or School
CHHS
Department or Program
Direct Entry Masters of Nursing
Degree Name
Master of Science
Recommended Citation
Vartabedian, Kristen, "A Quality Improvement Project: Enhancing Nursing Knowledge and Patient Safety in the Prevention of Hospital-Acquired Pressure Injuries (HAPIs) in a Medical-Surgical Unit" (2026). Master's Theses and Capstones. 2100.
https://scholars.unh.edu/thesis/2100