Document Type
DNP Project
Department
School of Nursing
Date of Degree
Spring 2025
Degree
Doctor of Nursing Practice (DNP)
Primary Advisor
Mercedes Echevarria, DNP, APRN, CNE
Keywords
Pressure ulcers; Hospital-acquired pressure injuries; HAPI prevention
Abstract
Background and Significance: A patient outcome that challenges nurse leaders in healthcare settings is the issue of pressure ulcers acquired in the facilities; also known as hospital-acquired pressure injuries (HAPI). Pressure ulcers can lead to patient discomfort, increased morbidity and healthcare costs. Because of chronic conditions, and the dangers of immobility, patients/residents are at risk for developing pressure ulcers, and as such mitigating the risk results in better outcomes for the patients and cost-effective measures. This project was conducted in TRC facility with a focus on the Long-Term Care (LTC) and Rehabilitation units. The setting included 45 beds in LTC unit with patients at risk for HAPI.
Aims: The aim of this project was to implement an evidence-based intervention to improve admission skin assessment and HAPI prevention; improve wound management; reduce the incidence of HAPI and improve staff knowledge of wound management.
Objectives: This project focused on decreasing the incidence of HAPI by 50%; achieving 100% compliance with wound assessment during admission; improving the nursing staff weekly skin assessment process, and compliance with treatment orders.
Methods: Chi-square analysis was used to compare pre and post implementation pressure injury rates, while paired two-tailed t-tests evaluated improvements in nursing knowledge, skin assessment adherence, and compliance with treatment orders.
Results: The implementation of the SSKIN bundle resulted in a significant reduction in HAPI with a pre-intervention value of 77%; post-intervention value of 92.5% and p = 0.05. Additionally, nursing staff knowledge and compliance with initial wound assessments improved to 100%, and adherence to weekly skin assessments increased by 96%. Staff knowledge scores significantly improved post-training (mean pre-test: A, mean post-test: B, p < 0.001), indicating the effectiveness of education and protocol adherence.
Conclusion: The SSKIN bundle effectively reduces HAPI occurrence when implemented systematically. To sustain these improvements, ongoing staff training, leadership engagement, and periodic auditing of skin assessments and compliance rates were implemented. Integration of the SSKIN bundle into standard operating procedures and electronic health record (EHR) prompts is expected to further support long-term adherence and patient safety.
Nursing Implications: Healthcare facilities can integrate the SSKIN bundle into routine care, ensuring continuous staff education and monitoring to optimize outcomes and minimize pressure ulcer risks.
Copyright Notice
©2025 Susan N. Omare. All rights reserved.
Recommended Citation
Omare, S. N. (2025). Implementation of SSKIN Care Bundle Protocol for Pressure Ulcer Prevention in TRC Facility. , (). Retrieved from https://hsrc.himmelfarb.gwu.edu/son_dnp/194
Open Access
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