Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2022


Doctor of Nursing Practice (DNP)

Primary Advisor

Dr. Mercedes Echevarria, DNP, APRN, CNE; Geraldine Mbaye, DNP, FNP-BC


Pressure ulcers; long-term care (LTC) facilities; SSKIN protocol


Background: Pressure ulcers are a major challenge in long-term care (LTC) facilities. Adult patients in LTC setting are at risk for developing pressure ulcers due to chronic medical conditions and comorbidities. Preventing the onset of these wounds is more cost-effective than treating pressure ulcers.

AIM/Objectives: The primary objective was to decrease the number of pressure ulcers by 50% within a three-month period. Secondary objectives were to achieve 100% compliance with completion of mandatory staff education, score on the posttest questionnaire, and compliance with mandatory staff documentation as instructed by the SSKIN protocol.

Methods: This DNP Project used a pretest and posttest design to compare the rates of pressure ulcers for patients exposed to the SSKIN bundle protocol versus the current standard of care alone. Retrospective data from two months pre-intervention was collected and compared to data two months post-intervention.

Results: There were more in-house acquired pressure ulcers in the post-intervention period versus the pre-intervention period (4 vs. 3). 100% of current nursing staff completed the education module. Although, there was a significant improvement in the pre and post test scores from 79.8% to 94.6%, the posttest score’s goal of 100% was not met.

Conclusions: The analysis showed the incidence of in-house acquired pressure ulcers was not statistically different (p = 0.62). While a significant clinical impact was not seen with the implementation of the SSKIN bundle on a three-month timeframe, maintaining the bundle and continuing education for nursing staff may be beneficial and effective. Some limitations to this project included the COVID-19 pandemic requiring isolations associated with decreased patient activities and mobility, and a lack of consistent nursing staffing.

Open Access


Included in

Nursing Commons



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