Implementing a Checklist to Reduce Hospital Acquired Pressure Injuries

Abstract

Problem: According to the National Database of Nursing Quality Indicators data, a 24-bed Surgical Intensive Care Unit in an academic medical center had a consistent trend of high hospital acquired pressure injury rates, exceeding the national benchmark for the three out of four quarters in 2021. Monthly unit-based data also reported at least forty more pressure injuries occurred in the unit in 2021 compared to other adult intensive care units. Purpose: The purpose of this quality improvement project is to implement a pressure injury bundle checklist to ensure staff use the evidence-based strategies that are needed to reduce the number of hospital acquired pressure injuries in their critically ill patients. Method: Nurses, certified nursing assistants and respiratory therapists were educated on the checklist. Copies of the checklist were placed at the nurse’s station and each staff member checked off the components that were completed throughout the shift. The de-identified checklists were then submitted in a folder at the end of each shift. Every week, the total number of collected checklists were compared to the total number of patients who were on the unit within that week to measure compliance. The number of monthly hospital acquired pressure injuries in the unit was tracked to measure the impact of the checklist. Results: Results showed 100% staff (n=262) were educated on the checklist and its process. Within the 14 weeks of implementation, staff nurse checklist compliance was 51% (1923/3763). The number of pressure injuries the month prior to implementation was 8. The number of monthly pressure injuries acquired in the unit decreased by 50% in the latter two months of the implementation period (n=3; n=4). Conclusions: Creation of and adherence to the checklist impacted the number of pressure injuries patients acquired while the checklist was in place on the unit.