Author Affiliations: Rehab Clinical Nurse Specialist (Dr McCray) and Instructor (Dr Donaldson), US Army, University of South Alabama, Mobile, Alabama.
Clin Nurse Spec. 2024;38(5):210-220. doi: 10.1097/NUR.0000000000000840.
PURPOSE/OBJECTIVES: The purpose of this quality improvement project was to reduce the hospital-acquired pressure injury (HAPI) rate to less than 1.177 per 1000 patient-days, increase staff competency and care in pressure injury prevention best practices through implementation of a nurse-driven pressure injury prevention program, to engage patients in pressure injury prevention through implementation of skin rounds, and improve staff adherence to documentation requirements for pressure injury interventions on an amputee/stroke unit.
DESCRIPTION OF THE PROJECT/PROGRAM: HAPIs can lead to negative patient outcomes including pain, infection, extended hospitalization, and morbidity. Using an evidence-based education strategy, the Agency for Healthcare Research and Quality pressure ulcer prevention clinical pathway and skin rounds were implemented. Focused education for nursing, staff competency, daily audits, HAPI rates, and documentation compliance were evaluated pre and post intervention.
The HAPI rate reduced from 1.177 to 0.272 per 1000 patient-days. After completion, the unit maintained zero pressure injuries, daily patient care for pressure injuries improved, documentation compliance increased, and staffs' knowledge and skill set in early identification, intervention, and prevention of pressure injuries heightened.
A nurse-driven pressure injury prevention program was successful in the reduction of the HAPI rate.
目的/目标：本质量改进项目的目的是将医院获得性压力性损伤（HAPI）发生率降低至每 1000 个患者日少于 1.177 例，通过实施护士主导的压力性损伤预防计划来提高员工在压力性损伤预防方面的能力和护理水平，通过实施皮肤查房让患者参与压力性损伤预防，并提高截肢/中风病房员工对压力性损伤干预措施的文档记录要求的依从性。
项目/计划描述：HAPIs 可导致负面的患者结果，包括疼痛、感染、延长住院时间和发病率。通过使用基于证据的教育策略，实施了医疗保健研究和质量机构压力性溃疡预防临床路径和皮肤查房。在干预前后，对护理、员工能力、日常审核、HAPI 发生率和文档记录合规性进行了重点评估。
HAPI 发生率从每 1000 个患者日 1.177 例降至 0.272 例。完成后，该病房保持零压力性损伤，每日压力性损伤护理得到改善，文档记录合规性提高，员工在早期识别、干预和预防压力性损伤方面的知识和技能得到提高。
护士主导的压力性损伤预防计划成功降低了 HAPI 发生率。
