Prevention of Pressure Injuries: Evidence-based proposal

Project objectives.

Pressure injury or HAPI has been a serious issue in the modern healthcare system, even though it is very preventable through evidence-based interventions. These kinds of injuries, besides compromising patient safety, augment morbidity, prolonged hospitalization, and inflated costs of healthcare. HAPI persistence illuminates the disconnects and discontinuities in the systematic implementation of preventive measures in clinical practice. This project is expected to reduce the incidence of hospital-acquired pressure injuries in hospitalized patients with the use of an evidence-based bundle of prevention. This project will aim at standardizing care, enhancing compliance with nursing practice, and enhancing patient outcomes. The project will also aim at instilling a spirit of responsibility and ongoing quality enhancement in the healthcare environment. This project can be implemented in line with the overall healthcare objectives of better patient safety, minimization of avoidable harm, and delivery of cost-effective care by dealing with clinical and organizational predictors of HAPI.

Literature Review

Background and Significance

Pressure injuries are focal loss or damage of the skin and tissue under the skin, most often on a bony prominence as a result of prolonged pressure, shear, or friction. These injuries are commonly known as a marker of the quality of healthcare, and they are commonly employed as a point of reference when it comes to the question of patient safety in healthcare facilities. The most vulnerable patients are those with poor mobility, older age, chronic diseases, dietary issues, and impaired or limited sensory perceptions (Mondragon & Zito, 2024).

The effects of the pressure injuries are not limited to the physical complications. Patients have been known to suffer pain, poor quality of life, and risk of infection. Organizational-wise, pressure injuries are related to high costs of healthcare in terms of prolonged hospitalization, follow-up therapy, and even legal considerations. According to Serafin et al. ( 2025), one of the most frequent avoidable adverse events in hospitals is pressure injuries. The occurrence of HAPI is an obstinate problem despite the presence of clinical guidelines and preventive structures. Such inconsistencies in applying evidence-based practices, the lack of staff training, and adherence to the current protocols can be attributed to this. These barriers should be considered when coming up with measures that can be taken to address them in an effort to improve patient outcomes and quality of care.

Evidence as support for the proposed change.

There is increasing evidence on the effectiveness of comprehensive and evidence-based interventions in preventing pressure injuries. HAPI incidence is greatly decreased by incorporating prevention bundles combining various measures. They are frequently repositioned, have comprehensive skin examinations, use pressure-relieving devices, and receive adequate nutrition. One of the most popular interventions that is supported is patient position change, which should be conducted on a regular basis to relieve constant pressure on a sensitive area. Likewise, regular skin checks help to prevent the occurrence of risk factors and take timely action. Tissue damage risk can also be reduced through the use of specialized support surfaces, which include pressure-relieving mattresses (Peterson et al., 2025).

Staff education is an important factor in the successful implementation of the prevention strategies, including clinical intervention. Research has shown that healthcare institutions that invest in continuous training and competency elevation have had higher compliance levels and better patient outcomes. Additionally, accountability is improved by the incorporation of monitoring and feedback systems and promotes long-term improvement. It is also possible to mention the use of interdisciplinary collaboration as one of the factors that led to the prevention of pressure injuries. The healthcare professionals, including nurses, physicians, dietitians, etc., are supposed to be able to communicate effectively to offer a comprehensive level of care. A team-based strategy towards the problem of pressure injuries would enable healthcare organizations to address the multifactorial nature of the problem. In general, the evidence base in favor of having a structured prevention bundle as a successful approach to HAPI prevention and patient safety is very strong, with the literature showing its extensive support.

The EBP Model: IOWA Model.

The IOWA Model of Evidence-Based Practice is a systematic model of carrying out research findings into practice. This model is one that best fits to solve such complex clinical issues, including hospital-acquired pressure injuries, since this model focuses on the appraisal of evidence and practical application. This commences by identifying a clinical problem or trigger, and in this scenario, it is the high prevalence of pressure injuries in the health care environment. After identification of the problem, it is evaluated to determine whether it is relevant and a priority for the organization. Since HAPI has a great influence on patient outcomes and health care expenditures, it is a high-priority problem.

Then, a multidisciplinary team is constituted to mentor the project. This group can consist of nurses, doctors, wound care practitioners, and quality improvement officers. The team will review and critique pertinent research evidence on the best practices. After an evidence appraisal, the team will choose a suitable intervention and initiate a pilot implementation in a particular clinical unit. The results of the pilot test are assessed to see its effectiveness and viability. In case the intervention proves to be effective, it is applied on a bigger scale and incorporated into everyday practice. Another important feature of the IOWA Model is the constant assessment and feedback, which will help to ensure that the intervention is effective in the long-term perspective. The continuous improvement and adjustment possible in this iterative process make it a perfect structure to adopt in this project.

Proposed Change

The intervention suggested is the introduction of a full bundle of pressure injury prevention in a medical-surgical unit.

Population/Sample: Adult, hospitalized, patients at risk of pressure injuries.
Sample Size: 30 -50 patients or so.
Setting: Medical-surgical unit
Inclusion criteria: Patients who have limited mobility, a high Braden Scale, or who are in the hospital long-term.
Exclusion Criteria: pressure injuries of stage 3 and stage 4.

Intervention components include:

Biannual loss of position to decongest pressure in patients.
Daily and regular skin examination.
Use of support surfaces and pressure-relieving mattresses.
Delivering nutritional examination and proper dietary interventions.
Providing consistent training for employees and their skills.

The process will be implemented through training of the staff, designing standardized protocols, and incorporating the intervention in the routine clinical processes. Guidelines and documentation tools used will be clear to allow uniformity and accountability. The ethical concerns to consider include maintaining patient confidentiality, making sure that the intervention will not disrupt the usual care, and that the institution would approve the intervention in the first place. The patients will receive the care that meets the clinical guidelines; additional risks will not be introduced (Hidalgo Tapia et al., 2025).

Outcomes

The ultimate deliverable of this project is the decrease in pressure injuries acquired in hospitals. The secondary outcomes will be good adherence to prevention measures by healthcare personnel and patient satisfaction. The patient health records, incident reporting, and compliance monitoring tools will be used to collect data. The quantifiable signs of the improvements will be pegged on the quantitative data, whereas a reflection of the effectiveness and feasibility of the intervention will be given by the qualitative data, including the feedback of the staff. The project will also improve the overall quality of care using evidence-based practice and improve clinical decision-making. These results will help to achieve long-term changes in patient safety and organizational performance.

Evaluation Plan

This project will be evaluated through a thorough process as well as outcome measures. Prior to the intervention, the baseline information about pressure injury incidence will be gathered. This information will be used as a point of reference. Data will be taken every now and then after implementation to measure the change in the rate of pressure injuries. Audits on compliance will be carried out to check compliance with the prevention bundle (Fulbrook et al., 2024). Some of the key areas that will be addressed in these audits include frequency of repositioning, recording of skin assessment, and support surface use. Also, the staff feedback will be gathered in order to recognize the barriers and facilitators to implementation. The feedback will offer useful suggestions regarding the feasibility of the integration of the intervention into the routine practice. We will conduct a statistical analysis on whether or not the changes we observed are significant and attributable to the intervention. This will be sustainably checked and assessed to make sure that the project will be efficient in the long run.

Dissemination Plan and Rationale

Dissemination of project findings is an essential part of the evidence-based practice since knowledge sharing and spreading can be performed, and effective interventions can be adopted. This project will disseminate the project results both internally and externally. Internal presentation will entail presentation of findings through staff meetings, training, and quality improvement forums. Such presentations will assist in strengthening best practices and their embrace in various units within the organization. On the outside, research could be published at professional conferences or could be written in peer-reviewed journals. Publication of the results to the rest of the healthcare fraternity helps in the development of evidence-based practice and facilitates the adoption of effective interventions elsewhere. The dissemination rationale is to make sure that the knowledge acquired throughout this project is applied to the continuous improvement of patient care. Sharing the results and experiences gained, healthcare institutions may collaborate to eliminate the rates of preventable diseases like pressure injuries.

References

‌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

Hidalgo Tapia, E. C., León Yosa, J., Olalla García, M. H., Clavijo Morocho, N. J., & Sanmartín Calle, Y. A. (2025). Effectiveness of Nursing Documentation Frameworks (SBAR, SOAP, and PIE) in Enhancing Clinical Handoffs and Patient Safety. Cureus. https://doi.org/10.7759/cureus.89957

Mondragon, N., & Zito, P. M. (2024, February 28). Pressure Injury. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK557868/

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

‌Serafin, A., Graziadio, S., Velickovic, V., Milde, T. C., Dinnes, J., Sitch, A., Coombe, A., McNichol, L., Armstrong, D. G., Lueck, H., & Kottner, J. (2025). A systematic review of clinical practice guidelines and other best practice recommendations for pressure injury risk assessment in the United States. Wound Repair and Regeneration, 33(2). https://doi.org/10.1111/wrr.70016

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Week 14 Assignment 1: EBP Proposal

Instructions
Include the following in your proposal:

· Purpose of the Project
· Literature Review – Background/Significance, Evidence to Support Proposed Change/Intervention
· EBP Model (remember, you are using the IOWA model for this project)
· Proposed Change – Elaborate (described the proposed practice change/intervention in detail; sample [inclusion/exclusion criteria, recruitment methods, type of population/sample, sample size] (consistent for Week 8), setting, ethical considerations, change/intervention)
· Outcomes – Elaborate (what are the outcomes [how will you measure the success of the practice change/intervention], data collection methods?)
· Evaluation Plan – elaborate (how will you evaluate if the project is successful or not in improving practice?)
· Dissemination Plan and rationale
· References List

APA format is required in your Microsoft Word document. Page length, excluding the title and references list, is between 7 to 10 pages.