CSI Summary
Available only to registered AACN.org users.
Project Topic:
Decreasing hospital-acquired pressure injuries (HAPI) and increasing true collaboration on the unit
Hospital, City and State:
Bayhealth Hospital Kent Campus, Dover, Delaware
Unit:
Cardiac step-down unit, 2North
CSI Participants:
- Aletta Decktor, BSN, RN
- Amber Carrow, BSN, RN
- Taylor Morris, RN
- Sarah Swan, MSN, RN, CCRN, CSC
Project Goals/Objectives:
- Complete dual skin assessments on 80% of patient admission and transfers
- Decrease number of HAPI’s on our unit 30%
- Improve True Collaboration Healthy Work Environment Assessment Tool (HWEAT) scores from 4.40 to 4.60
Project Outcomes:
- Dual skin assessments completed on 90% of patient admission and transfers
- Decreased HAPIs 67% on our unit per skin prevalence data
- Increased HWEAT True Collaboration standard from 4.40 to 4.43
- These outcomes resulted in a positive estimated annual fiscal impact of $43,518
Project Overview:
The HAPI rate on the unit continues to be one of our largest areas in need of improvement on our unit dashboard. The HWEAT True Collaboration standard was our lowest score at 4.40. HAPIs cost an average of $14,506 per event due to increased infection, delayed wound healing, pain, and delayed discharge.
To decrease the incidence of HAPIs and increase true collaboration on the unit, the CSI team implemented a project to increase morale while providing education and tools to improve HAPI incidence. We kicked off our project by educating staff about the purpose and provided visual tools to help remind staff of our goal of decreasing pressure injuries. We printed posters and put them behind the nurse’s station for a visual reminder, and included the project in our daily huddle and charge nurse handoff. We created a number of weeks without a HAPI poster to keep staff informed of the project’s progress.
As a result of our project, HAPI incidence decreased from 3 to 1. The feedback about our project has been positive, and due to having the poster in the unit, education has spread from our unit to physicians, other hospital staff, and family members. This project has allowed nurses and nursing assistants to be more diligent about skin prevalence and getting all of our patients out of bed and as mobile as possible.
Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.
Disclaimer
The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.