Reducing HAPI on a Medical Surgical Telemetry Unit

Abstract Problem: Hospital-acquired pressure injuries (HAPI) are a global issue that harms patients, prolongs lengths of stay, and increases hospital costs and financial burdens. Because HAPIs are preventable, hospital organizations worldwide are implementing prevention strategies to improve the quality of care and quality of life and decrease costs associated with them. Context: The 24-bed medical-surgical telemetry unit is one of five adult inpatient units within a Northern California hospital. The patient population includes an increased number of patients who are at risk of HAPI. The unit struggles with HAPI prevention, and the staff is challenged with implementing proper HAPI prevention strategies. Interventions: A HAPI committee was formulated and tasked with developing a quality improvement project to address the increased number of HAPIs. The project’s interventions aim to implement a static overlay mattress for all patients at high risk of HAPI. Other interventions include staff education and training, continued use of current HAPI prevention strategies, and early identification and escalation of at-risk patients. Measures: The measures for this project were the implementation of the static overlay mattress for patients with a Braden Score of 18 and less, documentation of PLOF and CLOF within 8 hours of admission, and documentation of a Braden assessment within 8 hours of admission. Results: Implementing the waffle overlay mattress for patients at high risk for skin injury led to decreased HAPI occurrences. Conclusions: Standardizing the waffle overlay mattress as part of the HAPI bundle led to a 34% decrease in HAPI occurrences from a baseline of 0.58 per month to 0.33 per month.