Date of Completion

Summer 2026

Document Type

DNP Scholarly Project

Academic Department

School of Nursing

Degree Type

Doctoral

Degree Name

Doctor of Nursing Practice

First Advisor

Melanie Brewer, DNSc, RN, FNP-BC, NEA-BC, FAANP

Abstract

Problem: Pressure Injuries are quality indicators that reflect the quality of care delivered to patients. With a hospital-acquired pressure injury rate above 12%, the project site exceeded the national benchmark average of 5-8% for acute inpatient settings. The cost of managing hospital acquired pressure injury ranges from $20,900 to $151,700 per patient, compounded by complications in a patient’s treatment plan.

Aim of the Project: To reduce the prevalence of HAPIs in a step-down unit to below 8% by implementing the Pressure Injury Prevention bundle. The PIP bundle, an evidence-based intervention, primarily aimed to educate the nursing team on its components and translate that knowledge into patient care.

Review of the Evidence: Research indicates that an effective pressure injury prevention bundle comprises components that effectively decrease HAPIs. The components include individualized skin care, frequent skin assessments, repositioning, use of pressure-relieving devices, timely collaboration among appropriate interdisciplinary departments, and education of healthcare staff. The components help preserve skin integrity, leading to improved patient outcomes.

Project Design: The quality improvement project used the Institute for Healthcare Improvement Plan-Do-Study-Act cycles, with the OhioHealth Change Management Model as a framework, to guide small, iterative changes that informed and shaped the course of the QI project. Plan-Do-Study-Act cycles addressed nurse education deficits and guided process improvements, while the OhioHealth Change Management Model supported an informed change process.

Interventions: Nurses were educated to implement components of the Pressure Injury Prevention bundle at the beginning of the project. Electronic health record compliance audits were conducted to assess nurses' adherence to components of the PIP bundle during patient care.

Significant Findings/Outcomes: With the implementation of the Pressure Injury Prevention bundle, hospital acquired pressure injury rates on the inpatient unit dropped from 12.2% before the intervention to 2% after the intervention was implemented. Electronic health record audit results also showed 94% PIP utilization compliance among the healthcare team, as compared to pre-PIP bundle implementation audits results which showed 50% compliance with the care site’s skin protocol.

Implications for Nursing: The project demonstrates the importance of employing evidence-based interventions to improve nursing quality indicators such as hospital acquired pressure injuries.  It highlights the role nurse education plays in empowering nurses to drive better patient outcomes.

Rights

Copyright, all rights reserved

Included in

Nursing Commons

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