Abstract
Background: Determining the incidence of facility-acquired pressure injuries (FAPI) in the long-term care (LTC) setting, as well as implementing a program to reduce the incidence of pressure injuries, is vital. The purpose of this Doctor of Nursing Practice project is to determine the effect of implementing a protocol to reduce FAPIs in older adults greater than 65 years of age who reside at a skilled nursing facility (SNF) in Florida. Methods: The Braden Scale was utilized to identify patients at risk of developing FAPIs; a cutoff point of 15 or less prompted users to implement a prevention protocol. A bundle of evidence-based interventions to prevent FAPIs was developed following the literature review, garnering stakeholder support, and examining the project site microsystem. The implementation of a bundle to prevent FAPIs included an algorithm and protocols for nurses to follow, the education of nursing staff, and participation during nursing huddles. Intervention: The protocol for FAPIs was initiated on 82 patients. Out of the 82 patients, 19 received the protocol despite Braden Scale scores above 15 based on nurses’ clinical judgment and assessment of comorbidities. Results: When the last quarter of 2019 was compared to 2018, the SNF Minimum Data Set (MDS) 3.0 quality measures remained the same. Conclusion: The project results suggested that alteration of the Braden Scale score cutoff point to initiate preventive interventions and nursing education on pressure injury prevention did not affect the incidence of FAPIs. More research is needed to determine if multiple ways to identify patients at risk, including a risk assessment tool with the incorporation of a through weekly skin assessment and identification of comorbidities with intrinsic and extrinsic patient risk factors, would mitigate the risk.