Date of Graduation

Summer 8-9-2019

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions

First Advisor

Mary Lou De Natale



Hospital Acquired Pressure Injuries (HAPI) can be costly for the hospitals and devastating for the patients. Most pressure injuries are considered preventable, but despite that a lot of Americans die from pressure injury related complications each year. Hospitals spend billions of dollars on pressure injuries which can be used for other treatments. A quality improvement project was created to address these concerns and improve patient care. There were 5 cases of HAPIs on the telemetry/stroke unit prior to the start of this project. Interventions were created to improve the outcome. After careful review of the related literature, HAPI prevention bundle was implemented on the telemetry/stroke unit. The bundle included: skin assessment every shift and a double RN skin check for every patient upon admission and transfer to and from the unit; wound care consult; skin picture upon admission and uploaded in patients’ hospital record; repositioning every two hours and the use of waffle cushion for all patients at risk for skin injuries. The staff were educated on the HAPI bundle and audits were performed to check effectiveness. The project was carried out over 6 months. The results supported a decrease in the number of HAPIs by more than 50% during the implementation of this project. Furthermore, there was only 1 case of HAPI on the telemetry/stroke unit after implementing the project. The data identified opportunities for improvement and the project showed the impact of the HAPI prevention bundle on preventing HAPIs on the telemetry/stroke unit.

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