Evaluating the Impact of Epic Integration and Dual Registered Nurse Check-Off on Pressure Injury Prevention Workflow Compliance

Authors

Darlene Y. Olowu, University of Texas Health Science Center at HoustonFollow

Author Biographical Info

Darlene Olowu, BSN, RN, CCRN, is a Doctor of Nursing Practice (DNP) candidate in the Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) program at UTHealth Houston. She currently serves as an intensive care unit (ICU) nurse at MD Anderson Cancer Center, specializing in oncologic critical care. Her scholarly interests include quality improvement, clinical informatics, and patient safety. Darlene is passionate about translating evidence-based practices into sustainable clinical outcomes and promoting interdisciplinary collaboration.

Date of Doctor of Nursing Practice Project Completion

2025

Faculty Advisor

Dr. Marie McBee

Abstract

Background

Hospital-acquired pressure injuries (HAPIs), particularly sacral and heel injuries, remain a persistent challenge in critical care settings, leading to increased morbidity, mortality, and healthcare costs.

Purpose

This quality improvement project aimed to improve compliance with a pressure injury prevention (PIP) workflow by integrating a dual RN check-off system within EPIC, thereby reducing sacral and heel pressure injuries. The project sought to enhance accountability, standardize documentation, and optimize compliance with evidence-based PIP measures.

Methodology

A Plan-Do-Study-Act (PDSA) framework guided the project implementation in an oncologic intensive care unit (ICU). Key interventions included: (1) EPIC integration of a dual RN check-off system to improve accountability in pressure injury prevention measures, (2) structured nursing education sessions addressing knowledge gaps, and (3) compliance tracking through audit reports. Pressure injury incidence and compliance with documentation protocols were monitored through descriptive statistics, compliance audits, and incidence tracking.

Results

Implementation of the dual RN check-off system resulted in a 75% reduction in sacral and heel pressure injuries during the intervention period. Compliance with pressure injury prevention protocols progressively improved following educational reinforcement, system integration, and real-time feedback mechanisms.

Implications

Findings highlight the effectiveness of structured verification processes, EPIC integration, and ongoing education in improving compliance and reducing pressure injuries. Expansion to other ICU settings is feasible with strong leadership support and interdisciplinary collaboration for sustainability. Future efforts should focus on continuous education, workflow optimization, and reinforcement strategies to sustain compliance and reduce HAPIs.

Keywords

Pressure Injury Prevention, Hospital-Acquired Pressure Injuries, Dual RN Check-Off, EPIC Integration, Clinical Workflow Improvement, Quality Improvement, Critical Care, Nursing Compliance, Clinical Informatics, Electronic Health Record, Oncologic ICU

Recommended Citation

Olowu, Darlene Y., "Evaluating the Impact of Epic Integration and Dual Registered Nurse Check-Off on Pressure Injury Prevention Workflow Compliance" (2025). Doctor of Nursing Practice Final Project Abstract. 49.
https://digitalcommons.library.tmc.edu/dnp_abstract/49