Hospital Acquired Pressure Injury (HAPI) prevention is a priority at Rush University Medical Center. In the spring and summer of 2022, wound ostomy care nurses (WOCNs) saw an upward trend in posterior (coccyx, sacrum and buttocks) hospital-acquired pressure injuries (HAPI). This increase coincided with the end of the acute care patients’ mattress lifespan.
In August 2022, the rate for posterior HAPIs in the acute care and rehabilitation units was 0.018%. The WOCNs retrospectively reviewed previous posterior HAPI cases from a root cause perspective, which revealed additional data related to high-mattress age. The team shared the data with senior leaders and requested that mattresses be replaced. Using data, guidelines and expertise, WOCNs explored mattress replacement options and worked with leadership to secure the purchase. The mattresses were delivered and replaced from April to June 2023.
Because the WOCNs were closely monitoring the rate of posterior HAPIs, they were able to align this with the life span of the mattresses in acute care. The team used data to advocate for timely mattress replacement, which has resulted in a significant decrease of posterior HAPIs for several months.
The WOCN team included Lisa Boudreau, MSN, RN, CWOCN; Andrea Deja Fidai, MSN, RN, CWON, CNL, CMSRN; Laura Hernandez, BA, MSN, RN, CWON, CNL; and Nicole Walkowiak, MSN, RN, CRRN, CWOCN, CNL.
