We’re Not Happy Until You’re Not HAPI

At St. Peter’s Health Partners in Albany, New York, 33% of patients in the cardiovascular intensive care unit (CVICU) and 8% of patients in the progressive care unit (PCU) experienced hospital-acquired pressure injuries (HAPIs). The Clinical Scene Investigator (CSI) team in these units focused on developing evidence-based strategies to reduce HAPIs in cardiac surgery patients.The CSI team provided education to the CVICU, PCU, and operating room staff (nurses and technicians) on the application of sacral foam dressings on all patients before cardiac surgery to prevent HAPIs. Additionally, the team educated nurses on the 4 Eyes Assessment, in which 2 nurses assess the patient’s skin for signs of breakdown and verify placement of the sacral foam dressing to prevent HAPIs. Both nurses and patient care technicians were educated on how to document the 4 Eyes Assessment in the electronic health record.The CSI team created a unit-based HAPI board where staff were recognized for their work; they expanded the HAPI project to the intensive care unit, catheterization laboratory, cardiac telemetry caring for preoperative cardiac surgery patients, and partner facilities; they incorporated the patient education into the preoperative class; and they included the HAPI prevention education in the new hire orientation.The CSI team at St. Peter’s Health Partners decreased the incidence of HAPIs in cardiac surgery patients in the CVICU and PCU by providing evidence-based education to increase the knowledge and compliance of staff in HAPI prevention and documentation.