Date of Award

Summer 2022

Document Type

Final DNP Paper

Degree Name

Doctor of Nursing Practice (DNP)



Faculty Chair

Dr. Dee Fuller


Dr. Douglas Cowser


Tanya Hudson, CRNP


Background: Pressure injuries affect approximately 2.5 million people in the United States and cost the American healthcare system more than $11.6 billion annually. Healthcare organizations have sanctions placed on them by government agencies to minimize the occurrence of pressure injuries to reduce financial burdens and poor patient outcomes.

Purpose: The project aimed to evaluate the effectiveness of reducing the incidence of hospital-acquired pressure injuries after implementing a pressure injury prevention bundle over eight weeks in a medical-surgical unit in a rural hospital in Alabama.

Methods: This quality improvement project consisted of three key components: educating nurses to complete a skin assessment with another nurse within two hours of admission, ensuring the turning of patients every two hours using the wall clock method, and utilizing the Braden scale tool to identify at-risk patients.

Results: Key results included statistical significance noting each participant (t=3.29, p<0.001) revealed an improvement in pressure injury reduction knowledge. Post-intervention data suggests 63.94% of the nurse participants completed the skin assessment tool reflecting a change in nursing behavior. Data extracted also showed a decline of 0.23% of HAPI’s on the unit, down from 0.63% to 0.41% of average incidences.

Conclusion: The implementation of this quality improvement project met the need to decrease pressure-related injuries affecting a population admitted to an adult medical-surgical hospital unit in Alabama. The participating nurses in the unit gained knowledge about reducing HAPI’s through evidence-based intervention tools.


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