Pressure Injuries Prevention in Hospitals PICOT Paper.

Hospital-acquired pressure injuries (HAPIs) are still a major problem in acute care facilities, especially in older adult patients of limited mobility. These injuries are a source of morbidity, are associated with hospitalization, and are medically expensive. HAPIs prevention is an issue within nursing practice that is in line with patient safety and quality improvement initiatives. In this paper, an evidence-based practice (EBP) project will be presented that aimed at minimizing the number of HAPIs by implementing a structured prevention bundle.

Demographics/ Health issues.

The targeted population group is comprised of the patients in the hospital, who are older adults, 65 years and above, as well as the patients who are unable to move freely in the acute care settings. Such a population is extremely susceptible to age-associated alterations in the organism, including a reduction in skin elasticity, slowing down of perfusion, and wound healing. The elderly are also affected by diabetes, heart problems, and malnutrition, which are other causative factors of pressure injuries, among others. The most important aspects of the contribution are restricted mobility since patients are unable to position themselves; it provokes long-term pressure over bony prominences. These risk factors guarantee the presence of the critical need in the prevention strategies, which guarantee the improvement in the patient outcomes and the minimization of the complications (Peterson et al., 2025).

High-risk Proposed Intervention and Health Equity.

The intervention suggested is based on a structured pressure injury prevention bundle. This bundle involves the use of the Braden Scale to identify the risks, repositioning patients every two hours, and standardized skin care procedures. It has been apparent that the combination of these interventions is more effective than any single practice in preventing. Such an intervention helps to create equity in healthcare delivery by offering high-risk patients equal standard medical care, regardless of any disruptions caused by personnel and provider practice. When the standardization is set, the diversity of the delivery of the care will be minimized, and the individuals who will receive the mitigating steps are the ones who are being exposed to the threats. In addition, the intervention is not in conflict with healthcare policies that strive to reduce hospital-acquired conditions and achieve better patient safety outcomes.

Bringing Comparisons with Old Practice or Study.

The comparison group involves the routine care, where there is no prevention bundle that is maintained consistently. Most medical facilities do not provide preventative mechanisms at an identical level across the environment because there are workflow inefficiencies, the lack of standardization, and workforce issues. The research indicates that this lack of consistency in the implementation of preventive measures leads to the emergence of more pressure injuries. Poor staffing and a lack of well-structured procedures are among the organizational barriers to compliance with prevention practices. On the other hand, packages of structured preventive aid in the compliance and coordination of care result in better patient outcomes (Mohamed Yusoff & Ibrahim, 2025).

Expected Outcomes

The expected result of the intervention was that the hospital-acquired pressure injuries would be less in the number of cases per 1,000 patient-days. The other outcomes that are desired will be the improvement of patient safety, reduction of the hospital stay, and minimization of healthcare spending. A systematic approach will also enhance nursing practice by ensuring accountability and encouragement of nursing practice in terms of observing the current evidence-based guidelines. Better patient outcomes can also be provided by increased interdisciplinary collaboration.

Implementation and Evaluation period.

The intervention is going to be conducted and measured within 8-12 weeks. This time will give the chance to train the staff, support the assimilation of the prevention bundle into the clinical practice, and collect the outcome data. During the pre-implementation phase, medical practitioners will be sensitized to the prevention bundle. The third step will be the implementation, which will be linked to the common practice of the intervention and testing the outcomes of the intervention by comparing the pre- and post-intervention data (Brunt & Morris, 2023). Mainly, it is a long period that is not too long to show any improvements, and on the other hand, it is practical in a clinical situation.

Nursing Science and Population Health Concepts Practice.

The theoretical framework of the given intervention lies in nursing science that affirms the importance of evidence-based practice, patient-centered care, and clinical expertise. The nurses should be in a position to develop the risk assessment, prevention strategy, and fulfill the patient outcomes. The risk of pressure injuries is also determined by social determinants of health (SDOH), access to healthcare resources, nutrition status, and socioeconomic status. These aspects can be discussed to address prevention in a more comprehensive way. The epidemiologic data will likely determine the trends and risk factors associated with pressure injuries and, therefore, enable the development of specific interventions with the high-risk groups. In addition, genomic and genetic factors could affect the integrity of the skin, tissue tolerance, and healing capacity, contributing to further pressure injury vulnerability. This project, with the help of nursing science, societal determinants of health, and epidemiologic/genetic information, promotes the overall approach to managing population health care and improves the overall patient results.

Conclusion

The hospital-acquired pressure issues problem is a healthcare-related problem, which is not contagious but chronic, especially among low-mobility elderly. The initial prevention bundle is also effective in reducing the morbidity of all these types of injuries, and such injuries can be reduced by the use of a systematic prevention bundle. This type of intervention leads to an improvement of patient safety and quality of care because it promotes the standardization of care, evidence-based practices, and other population health elements. According to the current PICOT project, the field of nursing science and evidence-based strategies should be regarded to enhance the healthcare outcomes.

References

Brunt, B. A., & Morris, M. M. (2023, March 4). Nursing Professional Development Evidence-Based Practice. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK589676/

Fulbrook, P., Lovegrove, J., Ven, S., Schnaak, S., & Nowicki, T. (2024). Use of a risk‐based intervention bundle to prescribe and implement interventions to prevent pressure injury: An observational study. Journal of Advanced Nursing, 81(9), 5315–5328. https://doi.org/10.1111/jan.16309

Mohamed Yusoff, M. I., & Ibrahim, M. I. (2025). Barriers to pressure injury prevention and associated factors among critical care nurses in Malaysia. BMC Nursing, 24(1). https://doi.org/10.1186/s12912-025-03963-4

Peterson, A., Fraix, M. P., & Agrawal, D. K. (2025). Preventing pressure injuries in individuals with impaired mobility: Best practices and future directions. Journal of Surgery and Research, 8(3). https://doi.org/10.26502/jsr.10020455

‌Appendix A: PICOT Statement

In hospitalized older adult patients aged 65 years and above with limited mobility in acute care settings, how does the implementation of a structured pressure injury prevention bundle compared to standard care affect the incidence of hospital-acquired pressure injuries over 8–12 weeks?

Appendix B: APA Writing Checklist

✔ Title page included (add in Word)

✔ Proper headings used throughout the paper

✔ Double spacing and 12-point Times New Roman font

✔ In-text citations included (APA format)

✔ Reference list formatted in APA style

✔ Logical flow and organization of ideas

✔ No bullet points used unnecessarily

✔ Academic tone maintained throughout

✔ Grammar and spelling checked

✔ Word count within required range (750–1,000 words)

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Assessment Description
Refer to the PICOT you developed for your evidence-based practice project proposal in the Evidence-Based Practice Project Proposal: PICOT assignment in Topic 3. If your PICOT required revision, include those revisions in this assignment. You will use your PICOT paper for all subsequent assignments you develop as part of your evidence-based practice project proposal in this course and in NUR-590, during which you will synthesize all of the sections into a final written paper detailing your evidence-based practice project proposal.

Write a 750-1,000-word paper that describes your PICOT. Include the following:

Describe the population’s demographics and health concerns.
Describe the proposed evidence-based intervention and explain how your proposed intervention incorporates health policies and goals that support health care equity for the population of focus.
Compare your intervention to previous practice or research.
Explain what the expected outcome is for the intervention.
Describe the time for implementing the intervention and evaluating the outcome.
Explain how nursing science, social determinants of health, and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population.
Create an appendix for your paper and attach the PICOT. Be sure to review feedback from your previous submission and revise your PICOT accordingly.
Complete the “APA Writing Checklist,” located in Class Resources, to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as the final appendix at the end of your paper.

Refer to “Evidence-Based Practice Project Proposal – Assignment Overview,” located in Class Resources, for an overview of the evidence-based practice project proposal assignments.

You are required to cite four to six peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN

4.1: Synthesize nursing science, determinants of health, and epidemiologic, genomic, and genetic data in the management of population health.

PICOT Final

Name_____________________________________

Complete your PICOT using your approved proposed nursing practice problem. If they were approved, you may use the population and intervention developed in your Topic 1 assignment. Include any necessary revisions in this submission. Refer to the “Example PICOT” below as needed for guidance on how to complete the PICOT.

PICOT Question
P	Population	Hospitalized older adult patients (aged 65 years and above) with limited mobility in acute care settings
I	Intervention	Implementation of a structured pressure injury prevention bundle (Braden Scale risk assessment, repositioning every two hours, standardized skin care protocol)
C	Comparison	Standard care without a consistently implemented structured prevention bundle
O	Outcome	Reduction in the incidence of hospital-acquired pressure injuries (measured as new cases per 1,000 patient-days)
T	Timeframe	8–12 weeks
PICOT Create a complete PICOT statement.	In hospitalized older adult patients aged 65 years and above with limited mobility in acute care settings, how does the implementation of a structured pressure injury prevention bundle compared to standard care affect the incidence of hospital-acquired pressure injuries over 8–12 weeks?
Problem Statement Create a problem statement for your PICOT. You will use this problem statement throughout your final written paper.	Hospital-acquired pressure injuries (HAPIs) are a serious and avoidable complication in the acute care facility among older adult patients with low mobility. This group in the population is specifically susceptible to age-related skin alterations, diminished tissue tolerance, and loss of the ability to reposition independently. It has been proven that the rates of pressure injuries can be significantly decreased in acute care settings through structured prevention methods, such as regular repositioning, the use of validated risk assessment tools, and standardized skin care protocols (Lovegrove et al., 2021). Nevertheless, even with the presence of these evidence-based interventions, lapses in the regular practice remain among the factors that lead to poor patient outcomes. Barriers at the organizational and system levels also make implementing pressure injury prevention strategies more difficult. Staffing differences, workflow inefficiency, and the absence of standardized procedures have been cited as the primary contributors to variations in compliance with prevention practices in healthcare settings (McMahon et al., 2025). The research dedicated to the implementation also suggests that the incorporation of structured prevention bundles into the daily clinical routines increases adherence and patient outcomes due to the better coordinated care provision (Edsberg et al., 2022). Also, clinical experience demonstrates that programmed preventive measures in high-risk groups, including immobile intensive care unit patients, lead to quantifiable changes in the incidence of pressure injuries (Martin-Meana et al., 2025). The practice gaps identified above need to be tackled as a structured and consistently put into practice prevention bundle to enhance patient safety, complications, and nursing care quality.

References

Edsberg, L. E., Cox, J., Koloms, K., & VanGilder-Freese, C. A. (2022). Implementation of pressure injury prevention strategies in acute care. Journal of Wound Ostomy and Continence Nursing, 49(3), 211–219. https://doi.org/10.1097/won.0000000000000878

Lovegrove, J., Fulbrook, P., Miles, S. J., & Steele, M. (2021). Effectiveness of interventions to prevent pressure injury in adults admitted to acute hospital settings: A systematic review and meta-analysis of randomized controlled trials. International Journal of Nursing Studies, 122, 104027. https://doi.org/10.1016/j.ijnurstu.2021.104027

Martín-Meana, C., González-Darias, J. M., Chinea-Rodríguez, C. D., Del Cristo Robayna-Delgado, M., Del Carmen Arroyo-López, M., Arias-Rodríguez, Á., Jiménez-Sosa, A., & Fariña-Martín, P. (2025). Effectiveness of additional preventive measures for pressure injury prevention in an intensive care unit: a retrospective cohort study. Nursing Reports, 15(7), 259. https://doi.org/10.3390/nursrep15070259

McMahon, J., McInnes, E., Wan, C. S., Straiton, N., Lam, L., Rodgers, J., Dickson, J., & Fulbrook, P. (2025). Effectiveness of organizational strategies for pressure injury prevention and treatment in acute hospital settings: a Systematic review. Journal of Advanced Nursing, 82(3), 2004–2021. https://doi.org/10.1111/jan.17090