Date of Scholarly Project Submission


Degree Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)



Faculty Chairperson

Dr Melissa Romero

Second Committee Member

Dr Theresa Durley

Third Committee Member

Dr Anne Stein


A pressure injury (PI) is a condition in which prolonged pressure or shear causes localized damage to the soft tissue and skin and is usually over a bony prominence (National Pressure Ulcer Advisory Panel (NPUAP), 2016). PIs can increase morbidity and mortality, increase length of stay, increase infection rates, increase healthcare costs and decrease quality of life (Agency for Healthcare Research and Quality (AHRQ), n.d.; Coyer et al., 2017). PIs are largely preventable yet continue to occur, despite the growing number of high-quality research articles that focus on this problem. Quality improvement initiatives are an effective way to translate evidence-based research into daily bedside practice. The purpose of this research was to utilize two evidence-based interventions to reduce hospital acquired PI HARM rates in the intensive care unit at a rural hospital in a Midwestern setting. Additionally, nursing self-reported compliance was assessed with the use of a survey to measure compliance over time. A retrospective pre-post design was utilized to compare ICU PI HARM rates prior to and after implementation of the interventions. Overall, PI rates increased from a mean of 0.53 in the ten months prior to implementation to a mean of 0.68 in the fourteen months after implementation. Nursing compliance was measured using a Likert-style questionnaire and was determined that the little variability over time suggested no changes in nursing compliance.