Problem & Purpose: Hospital-acquired pressure injuries (HAPIs) increase patients’ risk for infection, prolong hospital stays, and contribute to severe morbidity and mortality. A medical- surgical unit at a suburban community hospital recorded a HAPI rate of 2.6% in FY 2023, up from 1.7% in FY 2022, exceeding the hospital target rate of <0.62%. This quality improvement project was developed using the Promoting Action on Research Implementation in Health Services Framework and aimed to reduce the number of HAPIs on a 32-bed unit by implementing the two-nurse skin assessment during admissions and transfers. Methods: This 15- week project aimed to achieve 100% adherence to the two-nurse skin assessment protocol and reduce HAPIs on the unit. Biweekly educational sessions and visual reminders were used to improve compliance. Weekly chart audits were performed to verify the completion and documentation of the two-nurse skin assessment, with results recorded in the Research Electronic Data Capture system. Real-time feedback was provided to staff to encourage adherence. Results: Adherence to the two-nurse skin assessment improved from 78% at the start of the project to 90% by week seven, with a sustained upward trend observed throughout the implementation period, despite minor fluctuations. Only one HAPI occurred during the project. Staff participation in biweekly education sessions reached 90%, with nurses reporting increased awareness of the assessment’s importance. Implications for Practice: Implementing the two- nurse skin assessment proved effective in decreasing HAPIs. Standardizing this protocol across hospital units aligns care with evidence-based practices. Continued staff education, and collaboration are essential for maintaining long-term success. Keywords: hospital acquired pressure injury, two-nurse skin assessment, quality improvement