Date of Doctor of Nursing Practice Project Completion
5-2026
Faculty Advisor
Dr. Linda Cole
Abstract
PURPOSE
This quality improvement project was intended to improve nurses’ use of existing pressure injury (PI) prevention protocols by 20%, ensure 80% of them can adequately stage PIs, 100% report adequate PI prevention knowledge, and 50% of patient admissions receive a comprehensive skin assessment by two nurses. This project took place in the intensive care unit of a hospital in San Antonio, Texas.
BACKGROUND
PIs are sources of pain and infection for patients and financially burden healthcare systems. Nurses are frontline workers with the capability to prevent PIs by being knowledgeable of prevention practices. Additionally, the two-nurse skin assessment is meant to improve the detection of PIs present-on-admission to optimize treatment and prevent their deterioration.
METHODOLOGY
Nurses received an in-service by the project manager explaining how to conduct a two-nurse skin assessment. The skin assessment was done within four hours of the patient being admitted to the unit. Assessments were collected weekly, and rounding with the nurses was done to ensure understanding of the project intervention. Charge nurses were enlisted as unit champions to remind nurses to complete the assessment. In addition to this, the project manager conducted in-services targeting PI staging and prevention practices using visuals and demonstrations. Pre- and post-intervention assessments were given to assess for improvements. Plan-Do-Study-Act (PDSA) cycles were used to track project progression and keep stakeholders informed.
RESULTS
The two-nurse skin assessment intervention did not meet the compliance goal of 50%, less than 100% of nurses reported adequate PI prevention, and there was a less than 20% increase in the use of prevention protocols. However, there was an average score of 91.4% on the staging assessment, with 85.7% them showing they can adequately stage PIs, surpassing the initial goal of 80%.
IMPLICATIONS
There was an improvement in PI prevention and staging knowledge, which is likely to reflect positively on the occurrence of PI’s acquired in the hospital.
Efforts to improve nurse’s knowledge of PI prevention should be routinely integrated into their practice.
Failure to meet the compliance goal of two nurse skin assessments was partly due to missing data. Future efforts should focus on methods to prevent gaps in data.
Lastly, future projects should focus on quantifying improvements in the occurrence of PIs.
Keywords
Pressure injuries, skin assessment, education
Recommended Citation
Karla Vazquez, "Improving Nurse Utilization of Protocols to Prevent Pressure Injuries and Increase the Detection of Pressure Injuries on Admission Using Skin Assessments and Education" (2026). Doctor of Nursing Practice Final Project Abstract. 205.
https://digitalcommons.library.tmc.edu/dnp_abstract/205