Standardized Hospital-Acquired Pressure Injury Assessment Protocol

Studying how evidence-based practice teams work in real hospital settings provides an opportunity to understand how to identify, study and improve deficiencies in the treatment process. In the article “Pressure Injury Prevention in Patients with Prolonged ED Stays Before Admission” the authors researched the connection between ED patients and the occurrence of pressure injuries and gave recommendations on prevention measures. As a result of a long study, the application of a new protocol, and the study of its effectiveness, the researchers were able to significantly reduce the number of HAPI in the hospital.

The purpose of the study was to evaluate standardized hospital-acquired pressure injury (HAPI) assessment protocol to identify its impact on the stay time of elderly patients in the emergency department (Edwards et al., 2021). The data was collected by a nurse-led evidence-based practice team over two years, based on the research on “increasing HAPIs in four acute care inpatient units” (Edwards et al., 2021, p. 46). The nurses analyzed existing protocols and developed new ones with the ED staff as it was the ED patients who had the highest ratings of HAPI. After more than two years of new protocol application, HAPI has dropped from 3.56 per 1,000 patient days to 1.53 per 1,000 patient days (Edwards et al., 2021, p. 46). Although the level of HAPI for patients with Prolonged ED Stays is still above average, however, a significant and permanent reduction in the number of cases has been achieved. Continuous data collection showed that the results were maintained for five months.

The study shows that it is necessary to monitor the data obtained and ask what factors influence the results obtained. It would be easy to say that acute care patients would be more susceptible to HAPI due to the nature of their disease. The evidence-based practice team decided to investigate this issue for other factors such as environment, the number of medical interventions, time spent in the ED, skin assessment, toileting, skin care, etc. (Edwards et al., 2021). As a consequence, they could reduce the number of HAPI by more than two times and keep this result.

Moreover, patients often encounter significant problems when transferring from one department to another. Departments should communicate with each other and discuss and investigate issues arising from interaction based on statistical and other indicators. In this case, the research team collaborated with “wound care and ED nurses, and emergency technicians to understand current care practices in the ED” (Edwards et al., 2021, p. 49). Joint work can help to significantly improve the condition and quality of a patient’s life, and reduce the rating of such intractable conditions as HAPI. Studying the experience of interaction between different departments and multilateral research of occurring issues helps in future nursing practice to track possible problems and cooperate with colleagues in their discussion and research.

Currently, infection control is a topic of current interest in evidence-based practice in nursing. First, a study on this topic would be helpful, as it causes significant anxiety among the population. It may be worth investigating the relationship between the emotional state with the spread of infectious diseases or the impact of public awareness programs. Second, nosocomial infection is a significant factor that can worsen the condition of patients, both healthy and already ill.

Nurses play a significant role in controlling and preventing infectious diseases in hospitals. As in the study discussed above, special protocols and infection-control policies already exist. These measures consist of wearing protective clothing, proper handwashing, cleaning the premises, and maintaining cleanliness. However, this does not mean that they cannot be revised, improved, and expanded. For example, studies conducted during the pandemic have shown the importance of proper ventilation in the fight against infectious diseases transmitted by airborne droplets (Correia et al., 2020). Two years of the pandemic have shown that we have many things to strive for and improve.


Correia, G., Rodrigues, L., Da Silva, M. G., & Gonçalves, T. (2020). Airborne route and bad use of ventilation systems as non-negligible factors in SARS-CoV-2 transmission. Medical hypotheses, 141, 109781.

Edwards, A., Sitanggang, N., Wolff, K., Role, J., Cardona, T., Sanchez, M., & Radovich, P. (2021). Pressure Injury Prevention in Patients with Prolonged ED Stays Prior to Admission. AJN The American Journal of Nursing, 121(2), 46-52.

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