Graduation Semester and Year
Summer 2026
Language
English
Document Type
DNP Project
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Michelle Hampton PhD, RN, NEA-BC
Abstract
A clinical gap was identified when reviewing a hospital acquired pressure injury (HAPI) dashboard from a 369- bed, acute care community hospital located in North Texas. Fifty percent of HAPIs acquired occurred in older adults, aged 60 or higher, who were admitted into the intensive care unit (ICU) from the emergency department (ED). A retrospective review of the electronic health records (EHR) demonstrated that none of the patients had received HAPI prevention interventions while they were in the ED and the inconsistent document of skin assessments resulted in identification of few HAPIs present on admission (POA). The purpose of this quality improvement project was to implement a hospital acquired pressure injury (HAPI) bundle in critically ill older adults admitted from the ED into the intensive care unit ICU. Evidence suggested that EDs are a prime location for HAPI identification and intervention, but many EDs do not have protocols to minimize these risks. Evidence related to HAPI prevention is multifaceted, but bundled approaches that include education, identification of high-risk patients, and acquisition of skin protective resources are commonly recommended. Patients with advanced age who are critically ill represent a population that is high- risk for HAPI development, and evidence suggests that HAPI prevention efforts are most successful when initiated early, ideally while these patients are still in the ED.
Keywords
emergency department, older adults, HAPI, identification AND intervention, intensive care admissions
Disciplines
Critical Care Nursing | Emergency Medicine | Geriatric Nursing | Public Health and Community Nursing
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Britt, Lisa M., "Early Pressure Injury Identification and Intervention in Emergency Department Older Adults who are Admitted into a Community Hospital Intensive Care Unit" (2026). Doctor of Nursing Practice (DNP) Scholarly Projects. 13.
https://mavmatrix.uta.edu/nursing_dnpprojects2/13
Included in
Critical Care Nursing Commons, Emergency Medicine Commons, Geriatric Nursing Commons, Public Health and Community Nursing Commons
Comments
Acknowledgements:
Michelle Hampton PhD, RN, NEA-BC
Emergency Department, Intensive Care Unit staff and managers at community hospital
Chief Nursing and Professional Services Officer at community hospital