Implementing a Pressure Ulcer Bundle

Background: A quality improvement DNP project in a rural southern hospital was implemented to improve hospital-acquired pressure ulcers by implementing an evidence-based pressure ulcer prevention policy and education. Framework: The Evidence-Based Practice framework utilized in the project's development, implementation, and evaluation was the John Hopkins Evidence-based Practice Model. Local Problem: The hospital had no pressure ulcer bundle in place. Design: Quality improvement project utilizing the plan-do-study-act cycle. Methods: An educational presentation on pressure ulcers and the steps to implement a bundle. A pre-and post-test using Pieper's Pressure Ulcer Knowledge Test, modified from Agency for Healthcare Research and Quality (AHRQ) website. Data Analysis: A pre-and post-test analysis, percentage of nurses on the medical surgical floor that attended the training, the number of Hospital Acquired Pressure Ulcers (HAPU) pre-and post-implementation, and the number of times the bundle was implemented post-educational sessions. Results: There was a 100% completion of the educational sessions by the wound care nurse before implementing the HAPU bundle. Participants scored higher during the post-test (M=87.524, SD= 6.534), a statistically significant mean increase of 4.891, 95% CI [1.621, 8.160], t(17) = 3.156, p= .006. The wound care nurse observed every chart. Information gathered from the review demonstrated 77.05% compliance with the implementation of the HAPU bundle. Conclusion: There was high compliance with the nurses attending the educational sessions and implementing the HAPU bundle. Implementation of preventative measures included in this bundle is considered best practice in the fight against HAPUs. The HAPU bundle have become part of hospital policy.