Author(s): Dana Vance, CPHQ
Clinical Outcomes Manager
Ohio Health Riverside Methodist Hospital

Kelly Juckett, BSN, RN, CV-BC
Administrative Nurse Manager
Ohio Health Riverside Methodist Hospital

Competency Domain: Performance & Process Improvement

Description: HAPIs affect up to three-million patients a year within the United States healthcare system. HAPIs have the potential of an increased risk for patients including a higher rate of mortality and decreased quality of life (Wassel et al., 2020). To reduce this risk for patients, OhioHealth Riverside Methodist Hospital (RMH) implemented an "on admission" and "on transfer" 4 eyes assessment in conjunction with a mobile EMR device to take pictures to significantly reduce the number of HAPIs occurring throughout the hospital. Come learn how to improve the care your patients receive - a promising pilot study! Picture This! Problem:Our acute care hospital has a high percentage of hospital acquired pressure injuries, HAPIs, and this initiative was directly focused on reducing the number of HAPIs in our organization. Measurement:HAPI's per 1,000 patient days compared to previous year, and unit and hospital annual targets. We used bar and line charts that were available to staff nearly real-time. Analysis:We engaged our data analytics team to determine if our results from pre to post intervention were statistically significant and they were! For example, three of our five critical care units had HAPI rates that were 51% lower, 67% lower, and 35% lower than baseline -- a statistically significant reduction! Implementation:Our intervention is a "skin-care bundle"Â that includes 1) performing a 4 Eyes Skin Assessment On Admission and On Transfer and 2) using our EMR's mobile device (Rover) to pictorially capture any skin-oriented conditions identified during the assessments. Quality professionals can easily apply our learnings to their organization. Results/DiscussionThis improvement resulted in 1) better capture of POA conditions; 2) early application of preventative care and treatments resulting in healed patients; 3) better HAPI attribution for targeted action; 4) timely and appropriate consults to our WOC team; and 5) a reduction in skin related complaints.