HAPI Days are here! A Nurse Led Initiative to Prevent Skin Injury

Terrie Beeson, MSN RN CCRN ACNS-BC and Audrey Glossenger, MSN RN-BC CCRN-K, Indiana University Health, University Hospital, Indianapolis, IN

Hospital Acquired Pressure Injury (HAPI), continues to be a national problem for many hospitals. To enhance resources available to nurses, the Wound Treatment Associate (WTA) course was offered. The purpose of this evidence-based practice (EBP) project was to determine if the WTA peer developed skin educational fair enhanced confidence, knowledge and HAPI rates.


A pre/post comparative design was utilized for the EBP collaborative project. A group of Clinical Nurse Specialists, educators, and WTA clinical nurses developed the content and curriculum of the skin fair using the EBP projects of the WTA nurses. A focus on skin and pressure injury prevention measures was determined as the overarching goal of the fair. The WTA’s were empowered to create fun and relevant educational content for stations related to their projects using an eye catching theme for the fair, “HAPI Days,” which was suggested by one of the WTA nurses. The content was structured into four stations: static air overlay usage, nasal tube taping and application of external fecal management device, completion of a Braden score and discussion of patient specific interventions, and review of 2016 NPUAP staging guidelines with application to assessment and documentation of a wound. A pre and post survey related to nurse confidence and knowledge was collected.


Leadership approved mandatory attendance of the fair that resulted in 378 nurses trained. The pre/post survey resulted in a 20% -30% increase in knowledge of nasal tube taping and static overlay. Braden and staging confidence increase up to 40%. In addition, HAPI rates decreased from average 2.0 to 0 for the month of October.    


Engaging nurses in WTA training program and EBP projects enhanced knowledge transfer for nurses and improved patient outcomes.