Dissertation
Perioperative Hospital Acquired Pressure Injury Prevention
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2026
Abstract
Background: Hospital-acquired pressure injuries (HAPIs) affect over 2.5 million patients annually in the United States and are associated with increased morbidity, mortality, length of stay, and healthcare costs. Surgical patients are at elevated risk due to prolonged immobility, positioning, and physiologic changes during anesthesia. Top performing organizations utilize HAPI risk assessment tools and evidence-based positioning protocols to improve patient outcomes. Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to reduce perioperative HAPI incidence at a large Midwestern academic medical center through implementation of a validated risk assessment tool (Scott Triggers®) and an evidence-based prevention bundle integrated into the electronic medical record (EMR). Methods: This quality improvement project followed the Iowa Model of Evidence-Based Practice. The intervention included development and planned implementation of an EMR-integrated risk assessment tool and prevention bundle, supported by targeted staff education. Data collection used a mixed-methods approach, including retrospective and prospective HAPI incidence data, EMR-derived adherence metrics, and pre- and post-education knowledge assessments. Independent two-proportion z-tests were used to compare pre- and post-test results due to anonymous survey collection. Planned analyses include Mann-Whitney U testing for HAPI rate comparisons and chi-square analysis for adherence. Findings: Ninety-four perioperative staff participated, with 84 completing both assessments. Mean knowledge scores improved from 63% to 92%, a 29-percentage point increase. Statistically significant improvements were observed across all items (p ≤ .005), with the greatest gain in identifying perioperative risk factors (+52%). Outcome data on HAPI incidence and adherence are pending full implementation. Discussion: Targeted education significantly improved staff knowledge of HAPI risk factors and prevention strategies. Although outcome data are pending, the intervention is supported by strong evidence. Implementation barriers highlight the importance of organizational readiness. EMR-integrated decision support is expected to improve adherence, reduce variability, and enhance patient outcomes.
Details
- Title: Subtitle
- Perioperative Hospital Acquired Pressure Injury Prevention
- Creators
- Andrew Pryor - University of Iowa
- Contributors
- Cormac O'Sullivan (Chair) - University of Iowa
- Resource Type
- Dissertation
- Project Type
- Poster
- Degree Awarded
- Doctor of Nursing Practice (DNP), University of Iowa
- Degree in
- Nurse Anesthesia
- Date degree season
- Spring 2026
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright © 2026 Andrew Pryor
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9985217824802771
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