Under Pressure: Pushing Down on Hospital-Acquired Pressure Injuries

In the face of a rising trend of hospital-acquired pressure injuries (HAPI), it was necessary to change the awareness and culture surrounding these events in my facility. Quarterly PI studies were our only data source on HAPI rates. Staff nurses were often uninformed about the data we were tracking by doing PI studies. A multi-disciplinary team was created to address issues regarding HAPIs. The strategies created and implemented by this team created a 48.8% reduction in HAPI over the 2018 fiscal year. 

Our goal was to reduce the incidence of hospital-acquired pressure injuries. We also wanted to track HAPIs more closely and consistently while increasing nursing understanding of PI studies and pressure injuries. We began looking at the possibility of tracking causative factors to follow trends and allow changes in nursing practice.

The multi-disciplinary team has collaborated to address the challenges in changing the culture around HAPIs. The practices we have put into place are starting to shape a new culture of pressure injury prevention. Monthly “Mini PI Studies” that began in February 2018 by each nursing unit have raised pressure injury awareness with front line nursing and created meaningful conversation on how to better prevent pressure injuries and improve documentation as well as give us better data trends. The wound care team adapted a root cause analysis (RCA) tool to be completed electronically by front line staff when a new HAPI is found. This RCA involves multiple hospital departments as needed, including radiology, surgery and the emergency department. This standard process will allow us to track circumstances between patients to more clearly identify potential trends.  This enhanced awareness, better tracking, and causative data have led to changes in our outcomes and the pulse of our organization.