Hospital acquired pressure injuries (HAPIs) are listed as serious reportable events and classified as “never events.” Nevertheless, more than 2.5 million people develop HAPIs in the United States every year with 60,000 dying from associated complications. HAPI rates at the site of this quality improvement initiative were high and required intervention. As a result, the Skin Response (SR) initiative was developed to bring a multidisciplinary team to the bedside within 20 minutes of an identified skin concern. This team consisted of the bedside registered nurse (RN), RN leader, physician, facilitator, nutritionist, and wound RN. Through a team approach, SR assisted with the identification, intervention, and implementation of a plan of care for any identified skin concern. The team worked to correct barriers within the electronic health record, develop relationships among the multidisciplinary team, and replace the use of unnecessary wound consultations with real-time education and support for the bedside RN. With the use of SR, there was a reduction in sentinel event HAPIs by 86% within 12 months and an estimated decrease in the cost of care of 2 to 14 million dollars. SR promoted an institution-wide culture change around skin care and HAPI prevention and continues to be practiced.
Jagger, S. E., Saber, D. A., & Poirier, P. (2022). Skin Response: A Multidisciplinary Approach to Pressure Injury Prevention. Journal of Nursing & Interprofessional Leadership in Quality & Safety, 4 (1). Retrieved from https://digitalcommons.library.tmc.edu/uthoustonjqualsafe/vol4/iss1/9