Hospital-acquired pressure injuries: The significance of the advanced practice registered nurse's role in a community hospital.
OBJECTIVE
Hospital-acquired pressure injuries (HAPIs) continue to be a persistent problem in the acute care arena. The purpose of this retrospective quality improvement study was to examine if the introduction of nurse practitioners (NPs), as wound care consultants (WCCs), without other interventions, impacted the HAPI rates in a community hospital.


METHODS
A retrospective, comparison design was used; 48 months of HAPI data (May 2010-2014) reported on the monthly National Database for Nursing Quality Indicators (NDNQI) survey was abstracted from hospital records. Data included the assessment of 10,752 patients and were divided into two groups for comparison: 24 months before and 24 months after NP hiring.


CONCLUSIONS
There was a strong, inverse correlation between the presence of NPs and number of patients with HAPIs (r = -0.73, p < .01), indicating that HAPI rates were significantly lower after NPs took on the role of WCCs. The odds of a HAPI occurring following introduction of the NP WCCs were 20% of the odds in the previous years.


CONCLUSIONS
Study findings suggest that NPs assuming a leadership role as WCCs may be instrumental in decreasing HAPI rates.
Nursing Institute - Cleveland Clinic Hillcrest Hospital, Mayfield Heights, Ohio.
Candice
C
Irvin
Nursing Institute - Cleveland Clinic Hillcrest Hospital, Mayfield Heights, Ohio.
Elizabeth
E
Sedlak
Nursing Institute - Cleveland Clinic Hillcrest Hospital, Mayfield Heights, Ohio.
Christine
C
Walton
Nursing Institute - Cleveland Clinic Hillcrest Hospital, Mayfield Heights, Ohio.
Susan
S
Collier
Office of Nursing Research and Innovation, Cleveland Clinic, Independence, Ohio.
Esther I
EI
Bernhofer
D006764:Hospitals, Community / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology* / Q000517:prevention & control; D009722:Nurse Practitioners / Q000592:standards / Q000706:statistics & numerical data*; D024802:Nurse's Role; D003668:Pressure Ulcer / Q000453:epidemiology / Q000517:prevention & control*; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies
Acute care; NDNQI; advanced practice nurses; nurse practitioners; pressure injuries; quality improvement; wound care consultants