Date of Award

Summer 8-22-2020

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Douglas M. Turner, PhD, RN

Second Advisor

Andrya R. Rivera-Burciaga, DNP, APRN, FNP-BC, ACHPNp


Practice Problem: Hospital-Acquired Pressure Injury (HAPI) is a serious problem in patient care and has deleterious implications for the patient and the healthcare system. A 530-bed acute care hospital in the Rio Grande Valley identified a similar challenge and implemented a HAPI preventive program.

PICOT: This evidence-based practice (EBP) project was guided by the following PICOT question: In the Intensive Care Unit/Medical Intensive Care Unit (ICU/MICU) patients aged 18 and older, does a pressure preventive bundle, compared to routine pressure injury care, reduce the incidence of pressure injury, within 21 days?

Evidence: The reviewed literature supported evidence of effective use of a pressure injury preventive bundle in reducing the incidence of pressure injuries in an acute care setting. Seven articles met the inclusion criteria and were used for this literature review.

Intervention: The evidence-based pressure injury preventive bundle are interventions that included consistent skin risk assessment and the application of a group of clinical practice guidelines composing of moisture management, optimizing nutrition and hydration and minimizing pressure, shear, and friction that were proven to prevent the occurrence of pressure injuries.

Outcome: Post-implementation findings showed that there was no reduction in the incidence of HAPI but significant decrease in the severity of the pressure injury from Stage two to Stage one.

Conclusion: The staff education, training, and implementation of an evidence-based bundle intervention to prevent the incidence of HAPI proved a positive outcome on reducing the pressure injury severity from Stage Two pressure injuries to Stage One pressure injuries.


Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor Nursing Practice.

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This work is licensed under a Creative Commons Attribution 4.0 License.