Abstract WP36: Proven Strategies for Educating Staff and Reducing Hospital-Acquired Pressure Injuries in Stroke Hospital Units

Abstract

Introduction: Hospital-Acquired Pressure Injuries (HAPI) are preventable complications that stroke patients are at risk for developing during hospitalization due to changes in mobility, nutrition, and continence as complications of stroke. The stroke units at a large teaching hospital saw an increase in HAPI’s during fiscal years (FY) 21 and 22 with 16 collective HAPIs in FY21 and 25 in FY22. Additionally, 12.5% of their unit-acquired HAPIs were reportable to the state’s Department of Public Health (DPH) in FY21 and 20% were reportable to the DPH in FY22. Nursing leadership hypothesized that a multi-year and multi-faceted plan would reduce unit-acquired HAPIs. Methods: In the first year of the plan, all RNs and Patient Care Assistants (PCAs) participated in a “Room of Wounds” education intervention in which they identified HAPI prevention errors in a simulation, matched appropriate dressings to wound images according to hospital policy, identified documentation gaps in a mock medical record, and completed a case study in which they applied the hospital’s Skin Injury Prevention Protocol (SIPP) to a patient scenario. The following year, the RNs all reviewed a handout on the hospital’s SIPP which included “Do’s and Don’ts” of documentation and participated in a Skills Day where an educational game was utilized identify wounds and appropriate dressing types. Additionally, unit leadership completed daily audits and provided timely feedback to RNs about patient care and documentation gaps. Results: Together, the neuroscience units saw a 48% reduction in HAPIs from FY22 to FY23 thus far with one of the units seeing a 71% reduction. In addition, none of the neuroscience units had a DPH reportable HAPI in FY23 thus far. Conclusion: Multi-faceted education approaches are critical when implementing education to counteract gaps in nursing care because they ensure that all learner types receive meaningful education. Consistent Auditing and feedback also improves patient care and staff accountability. A multi-faceted approach is a successful strategy that can be utilized when providing education about HAPI prevention, a major risk to patients after stroke, to staff members of multiple roles within the hospital’s stroke units.