Graduation Semester and Year
Fall 2026
Language
English
Document Type
DNP Project
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Cathy Brown, DNP, APRN, AGPCNP-BC
Abstract
Hospital-acquired pressure injuries (HAPIs) remain a national and global challenge, contributing to preventable harm and negatively affecting patient safety, quality of care, and clinical outcomes. Current evidence underscores opportunities to strengthen pressure injury prevention strategies. Purpose: This quality improvement project implemented an evidence-based pressure injury prevention (PIP) bundle to reduce HAPI rates by improving nursing knowledge and attitudes and increasing adherence to protective dressing application and repositioning practices. Methods: The PIP bundle consisted of targeted education, monitoring of prophylactic dressing application, and structured repositioning strategies focused on turn frequency and offloading angle. Data were collected via pre- and post-intervention surveys, chart reviews, and simulated turning assessments using wearable sensors. Outcome measures included nurse knowledge and attitudes, dressing adherence, turn-rate compliance and adequacy, and HAPI incidence. Results: HAPI rates had a relative rate reduction of 60%. Knowledge scores did not significantly change among nursing staff from pre‑ to post‑intervention (Mdn = 12.5 to 13.0; p = 0.18); however, attitude scores increased significantly (Mdn = 40.5 to 42.5; p = 0.035). Prophylactic dressing adherence remained consistently high, at 88%. Turn‑angle adequacy significantly improved, with all staff participants achieving adequate angles post‑intervention (p < 0.001). Appropriate turning frequency increased significantly from 78.8% to 86.8% (χ²(1) = 13.50, p < 0.001). Conclusions: Implementation of a PIP bundle strengthened adherence to evidence-based HAPI prevention practices by providing focused education, standardizing proactive protective dressing use, and leveraging technology-driven feedback. Findings demonstrate the effectiveness of the PIP bundle in reducing preventable pressure injuries and associated harm, supporting its potential for broader dissemination across additional units and care settings.
Keywords
Hospital-acquired pressure injury, HAPI, Pressure ulcer, ICU, Prevention, Bundle, Quality improvement
Disciplines
Critical Care Nursing | Medicine and Health Sciences | Nursing | Nursing Administration | Quality Improvement | Technology and Innovation
License
This work is licensed under a Creative Commons Attribution-No Derivative Works 4.0 International License.
Recommended Citation
Thompson, Vickey, "Hospital-Acquired Pressure Injury Reduction: A Quality Improvement Bundle Strategy" (2026). Doctor of Nursing Practice (DNP) Scholarly Projects. 26.
https://mavmatrix.uta.edu/nursing_dnpprojects2/26
Included in
Critical Care Nursing Commons, Nursing Administration Commons, Quality Improvement Commons, Technology and Innovation Commons