Adapting a Pressure Injury Prevention Process to Decrease Deep Tissue Pressure Injuries

PURPOSE: The aim of this quality improvement project was to reduce hospital-acquired deep tissue pressure injuries (DTPIs) within 6 months of implementation using a prevention bundle that focused use of a polymeric membrane dressing. PARTICIPANTS AND SETTING: The project was conducted in the intensive care and progressive care units of a rural hospital in the Midwestern US (Mattoon, IL, USA). Participants included adult patients at risk for PIs and nursing staff responsible for their care. The hospital serves a predominantly rural population, with a patient mix that includes many elderly and critically ill individuals. APPROACH: Guided by the Institute for Healthcare Improvement's Psychology of Change framework, the project used surveys, observations, and chart audits to assess knowledge and protocol adherence. Baseline data informed the project's design, with tools including pre- and post-implementation surveys to measure knowledge and adherence. OUTCOMES: No hospital-acquired DTPIs nor progression of existing DTPIs have been detected since initiation of the project. Surveys show increased nursing knowledge and improved protocol adherence. IMPLICATIONS FOR PRACTICE: This project improved patient care, enhanced decision-making, and reduced hospital-acquired DTPIs, yielding fiscal benefits in the inpatient care unit where it was implemented. Next steps include strategies to sustain improvements and expand the prevention bundle to other hospital units.