Content area
Full Text
Hospital-acquired pressure injuries are a preventable nursing-sensitive indicator. Two registered nurses completing skin assessments on patient admission or transfer is a viable strategy to identify pressure injuries early. Reducing hospital-acquired pressure injuries is an achievable nursing outcome.
Literature Summary
* Hospital-acquired pressure injuries (HAPIs) are preventable events that are not reimbursed (Centers for Medicare & Medicaid Services, 2022).
* HAPI treatment costs hospitals $26.8 billion annually in the United States (Padula & Delarmente, 2019).
* Patients should have a complete skin assessment as soon as possible after admission or transfer (Haesler, 2019).
* Registered nurses need to assess and document pressure injuries within 24 hours of patient admission to prevent the injury from being considered hospital-acquired (National Database of Nursing Quality Indicators, 2021).
* A skin assessment completed by two registered nurses on patient admission and transfer to an inpatient unit decreases HAPIs (Boyes & Sederstrom, 2018).
CQI Model
Plan-Do-Study-Act (PDSA) model (Institute for Healthcare Improvement, 2017)
Quality Indicator with Operational Definitions & Data Collection Methods
* HAPIs are skin and tissue damage that occurs as a result of pressure exerted over bony prominences during an inpatient hospital stay (Rondinelli et al., 2018).
* Community-acquired pressure injuries (CAPIs) are pressure injuries that develop prior to hospital admission (Kirkland-Kyhn et al., 2019).
* Data on HAPIs were collected as part of the hospital's quarterly pressure injury prevalence survey and entered into an electronic Excel file.
Clinical Setting/Patient Population/Average Daily Census
31-bed medical-surgical unit with a subspecialty in rehabilitation in a 555-bed urban teaching, safety-net hospital in the southwestern United States; average daily census 30 patients
Program Objectives
* Decrease the number of HAPIs by 50%.
* Increase the number of CAPIs identified within 24 hours of admission by 50%.
* Improve patient risk for pressure injuries by discharge as evidenced by a 5% improvement in mean Braden Scale score.
Hospital-acquired pressure injuries (HAPIs) are one of two hospital-acquired conditions with increased occurrence, second only to surgical site infections (Agency for Healthcare Research and Quality, 2020). HAPIs are painful, odorous, and disfiguring. They cause extended patient length of stay and higher acuity, 30-day readmissions, and mortality than for patients without pressure injuries (Pls). Reimbursement is denied for costs of care and treatment for patients who experienced...