Date of Award
2026
Document Type
Doctor of Nursing Practice (DNP)
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
Committee Chair
Haley Hoy
Committee Member
Shikha Modi
Committee Member
Ariam Yitbarek
Subject(s)
Bedsores--Nursing, Bedsores--Prevention, Patients--Positioning, Medical protocols
Abstract
Worldwide, hospitals implement comprehensive policies to support the prevention of hospital-acquired pressure injuries (HAPIs). Despite decades of effort, HAPIs continue to have significant impacts on patients and cost hospitals billions of dollars annually. Nursing attitudes on HAPI prevention, implicit bias, and the complexity of policies written to prevent HAPIs may be contributing factors. Review of HAPI data for the acute stroke unit in a large, urban, level one teaching hospital in the northeast United States showed years of poor outcomes despite hospital initiatives and education for nurses regarding the prevention of pressure injuries. A comprehensive HAPI prevention protocol was an evidence-based solution supported by the literature to reduce HAPIs. The comprehensive HAPI prevention protocol was comprised of a turn team of patient care technicians who had received special education on effective repositioning of patients, the use and documentation of designated repositioning supplies, and validation of a nutrition consultation order for patients with a Braden skin risk score of 18 or less. Prior to project implementation of the protocol involving a designated turn team, four HAPIs occurred on the unit over a timespan of three months. After implementation of the protocol, zero HAPIs occurred on the unit over a three-month time period. Additionally, the frequency of repositioning at-risk patients increased, as did the use of repositioning supplies. The number of nutrition consultations ordered within 24 hours of admissions also increased. Additionally, pre- and post-implementation surveys showed a statistically significant improvement in the team’s attitudes regarding HAPI prevention.
Recommended Citation
Saale, Jani North, "Implementation of a comprehensive hospital-acquired pressure injury protocol" (2026). Doctor of Nursing Practice (DNP). 157.
https://louis.uah.edu/uah-dnp/157