Date of Award

Summer 2023

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Faculty Chair

Dr. Crystal Fuller

Preceptor

Dr. Cathy Byers

Abstract

Background: Hospital - Acquired Pressure Injuries (HAPIs) are an enormous problem for healthcare institutions and patients. HAPIs are painful, can lead to additional infections, increase the length of stay, and even cause death. Hospitals around the country are experiencing increases in the number of HAPIs. This project was implemented in a medical-surgical unit of a local urban hospital in the southeastern United States. The medical-surgical unit reported an increase in the number of HAPIs that exceeded the national average of 3%.

Purpose: The purpose of this quality improvement project was to apply an interprofessional approach to reduce HAPIs using a range of motion exercises with patients on a medical-surgical floor who scored an 18 or less on the Braden Scale.

Methods: The nursing staff was trained on ROM exercises, documentation, and frequency of intervention (two times in 24 hours). The interprofessional collaboration included the wound care nurses providing education and support, physical therapists providing education on how to perform range of motion exercises, and the staff nurses implementing the ROM exercises. The electronic health record (EMR) was audited weekly to evaluate adherence to the protocol. Retraining was provided as needed. ROM exercises compliance and HAPIs were measured during the project time frame and compared to the pre-project implementation data.

Results: Results of the paired-t test indicated that there is a significantly large difference between Before (M = 3, SD = 0) and After (M = 2, SD = 0), t(0) = Infinity, p < .001. The incidence rate for patients on a medical/surgical floor over 2 months was calculated at 2.0%, a decrease from the national average representing a successful intervention.

Conclusion: This project revealed that Interprofessional collaboration using ROM exercises can reduce the incidence of hospital-acquired pressure injuries in high-risk patients.

Available for download on Tuesday, July 23, 2024

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