Problem Pressure injuries lead to a decreased quality of life and increased hospital stays, morbidity, and mortality. Compared to the national benchmark of 3.3% of adult hospitalized patients who develop hospital-acquired pressure injuries annually, adult patients on a thoracic/surgical intermediate care unit at an academic hospital exceeded the benchmark in five out of eight quarters in 2023. Purpose The purpose of this quality improvement project is to implement and evaluate an evidence-based pressure injury prevention checklist inclusive of a bundle of interventions to decrease the number hospital-acquired pressure injuries among adult inpatients in a thoracic/surgical intermediate care unit. An average of 400 adult inpatients per year are expected to be impacted by implementation of this initiative. Methods The project was implemented over 15 weeks. Staff nurses were educated on how to implement the checklist the week before implementation. The individual door for each patient room was supplied with a checklist for nurses to complete each shift. Checklist completion was audited by the charge nurse and project lead during the charge nurse equipment checks for the previous shift. The data on checklist completion was recorded into a secure web application, REDCap, to measure adherence. The percentage of patients with a reported HAPI was measured by the project lead through the hospital’s monthly pressure injury reports. Results During the fifteen weeks, the checklist completion ranged from 10% to 83% and the checklist audit completion ranged from 14% to 85%. The run charts for completion were analyzed and revealed no shifts or trends. According to hospital reports, zero pressure injuries were reported on the unit during implementation. Conclusions Findings suggest the method and strategies have been effective in decreasing pressure injuries; however, there are barriers such as staff compliance that should be researched further in order to determine the sustainability of the checklist. Keywords: Pressure injury prevention, HAPI, HAPI prevention