Date of Award

January 2025

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Anna-Rae Montano

Abstract

Hospital-acquired pressure injuries (HAPIs) affect millions of patients a year, impacting patient safety and creating a significant financial burden for healthcare systems. Inadequate reporting and tracking of HAPIs lead to delays in care, inaccurate data reporting and missed opportunities for quality improvement. This is in large part due to a lack of training and education around HAPIs, poor communication of injuries during hand-off and a lack of system integration. A process improvement program to improve the reporting and tracking accuracy of HAPIs was piloted on two post-surgical units in a large urban cancer center. This initiative combined comprehensive training via a web-based module, and the implementation of an electronic pressure injury risk report that was incorporated into morning huddles and in the hand-off process. Pre and posttests completed by participants revealed a significant increased sense of self-efficacy in identifying, reporting and tracking HAPIs after training (p <.001). The units also sustained a decrease in wound care orders placed on high-risk patients and zero confirmed pressure injuries in the month immediately after implementation. Implementing targeted training and leveraging enhanced reporting via the electronic health record can improve compliance with national standards and improve patient safety overall. A collaborative, interdisciplinary approach and reinforcement of processes are essential in process improvement sustainability.

Comments

This is an Open Access Thesis.

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