Implementation of a Turn Team to Reduce Hospital-Acquired Pressure Injuries in a Medical Intensive Care Unit

Authors

• Heather A, AdairFollow

Author Biographical Info

Heather Adair, BSN, RN, is a Doctor of Nursing Practice student in the Adult-Gerontology Acute Care Nurse Practitioner program at Cizik School of Nursing, The University of Texas Health Science Center at Houston. Her clinical experience includes critical care nursing in the Medical Intensive Care Unit. Her scholarly interests include patient safety and quality outcomes, pressure injury prevention in critical care, quality improvement, evidence-based practice, and implementation science.

Date of Doctor of Nursing Practice Project Completion

2026

Faculty Advisor

Dr. Karla M. Abela

Abstract

Implementation of a Turn Team to Reduce Hospital-Acquired Pressure Injuries in a Medical Intensive Care Unit

PURPOSE

The project aimed to reduce hospital-acquired pressure injury (HAPI) rates in a Medical Intensive Care Unit (MICU) by improving nurses' knowledge of the Braden Scale and implementing a structured two-nurse turn team workflow to reposition high-risk patients every two hours.

RESULTS

Repositioning compliance improved substantially and consistently exceeded the project goal of 90% after implementing a pod-based workflow. The HAPI prevalence rate decreased from a baseline of 8% to below the project goal of ≤5% during implementation but was not sustained in the final month. Staff surveys also showed improved knowledge, confidence, teamwork, and acceptance of the intervention.

BACKGROUND

The MICU had the highest HAPI prevalence in a large academic hospital and lacked a standardized process to ensure consistent repositioning of patients with Braden Scale scores of ≤18.

IMPLICATIONS

A structured, evidence-based repositioning workflow strengthened adherence to pressure injury prevention practices and improved nursing knowledge, teamwork, and accountability. Sustained leadership support, ongoing staff education, and adaptable workflows are essential to maintaining quality improvement initiatives and enhancing patient safety in critical care settings.

METHODOLOGY

An evidence-based two-nurse turn team intervention was implemented in a 26-bed MICU using Kotter’s 8-Step Planned Change Model. Implementation was evaluated using compliance audits, monthly HAPI prevalence data, and pre- and post-staff surveys.

Keywords

pressure injury prevention, Braden Scale, turn team, quality improvement, critical care

Keywords

pressure injury prevention, Braden Scale, turn team, quality improvement, critical care

Recommended Citation

Heather A, Adair, "Implementation of a Turn Team to Reduce Hospital-Acquired Pressure Injuries in a Medical Intensive Care Unit" (2026). Doctor of Nursing Practice Final Project Abstract. 228.
https://digitalcommons.library.tmc.edu/dnp_abstract/228