Innovation in HAPI Prevention and Education

Emily Rodriguez, MSN, RN, CMSRN, Agnieszka Hedberg, BSN, RN, CMSRN, Trina Cousins, BSN, RN, CMSRN
Members: Slav Spyrka, BSN, RN, CMSN, Yadira DiPalomares

With eight newly hired RN1s and an uptick in Hospital-Acquired Pressure Injuries (HAPI), the 7 South Atrium Skin Prevalence Team rose to the challenge to develop an innovative intervention.

A needs assessment conducted in August 2019, coupled with months of chart auditing, demonstrated a need for re-education in areas around documentation, wound measurement, available products, and dressing changes that are aligned with the Nares Acquired Pressure Injury (NAPI) bundle.

As a result, the team developed an interactive and educational workshop to address these needs for all clinical staff. The comprehensive one-hour workshop was led by different members of the skin committee, and held over one week in November 2019 for the unit’s 70 nurses, PCTs and NA2s.

The objectives were to address identified areas from the needs assessment through education and hands-on training. Skills were validated with the teach-back method. The components included case studies, skin assessment, especially during a new admission, pressure injury measurement and documentation, pressure injury prevention, reinforcing the NAPI bundle, and how to adequately dress each stage of a pressure injury.

An evaluation that was conducted after the workshop to assess skills and knowledge revealed that 85% of participants were “confident” or “very confident” in NAPI prevention. All participants found the length of the workshop was time-worthy.

Themes highlighted from the subjective data demonstrate how the information was presented in clever ways by using Kahoot and games. Staff also really enjoyed the hands-on approach.

The workshop had an impact on the unit’s quality as well. Staff identified more pressure injuries upon admission than the previous fiscal year. Most notably, four NAPIs were identified upon admission in Fiscal Year 2020 compared to none the previous year.

Pressure injuries are now identified sooner so that adequate interventions can be made. The data demonstrate the increase in knowledge gained and the development of a culture as a result of this workshop.

Skin workshop graph

NAPI bundle and prevention graph