Implementing a Turn Team Process to Reduce Hospital-Acquired Pressure Injuries on a Telemetry Unit at a Hospital in the Midwest

Abstract

Problem: Pressure injuries (PI) are localized wounds to the skin and soft tissues that typically result from sustained pressure on specific areas of the body (Zaidi & Sharma, 2024). Hospital-acquired pressure injury (HAPI) refers to pressure injuries that develop while a patient is in the hospital (Rondinelli et al., 2018). PI can cause patients to experience pain, decreased feelings of dignity, increased feelings of depression and anxiety, reduced levels of social activity, difficulty sleeping, and impaired cognitive function (Roussou et al., 2023). The Advanced Cardiac Care Unit (ACCU) at Missouri Baptist Medical Center experienced an increase in HAPI cases: 4 in 2022, 12 in 2023, and 16 in 2024. Method: This quality improvement project utilized a descriptive, observational design. A turn team process was implemented over an eight-week period. To enhance compliance with the two RN skin assessment, the assessment process was integrated into the turn team program. Additionally, satisfaction surveys were distributed to staff before and after the eight-week implementation to evaluate staff satisfaction with the unit’s previous process for completing every two hour turns and the turn team process. Education on PI were also provided to staff. Data were collected through retrospective chart review. Results: The pre-implementation phase had a total of four PIs and the post-implementation phase had two acquired PIs. Staff compliance with patient turning increased from 85.25% to 100% and wedge utilization increased from 11.5% to 37.5%. Compliance with completing two RN skin assessment decreased from 96.72% to 95.83%. Survey results showed significant improvements in overall satisfaction, feeling of ease of use, and a feeling of positive contribution to team work with the turn team process