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Pressure injuries are a major indicator of patient safety and quality of care in acute healthcare settings. Evidence supports the use of structured skin bundle approaches to reduce the incidence and severity of hospital-acquired pressure injuries (HAPIs). territory hospital implemented a comprehensive Skin Bundle program to standardize prevention practices and embed pressure injury prevention into routine clinical care.
Methods:
A longitudinal quality improvement initiative was conducted from 2014 to 2024 across acute and critical care units at TERITORY HOSPITAL. The Skin Bundle included standardized risk assessment using the Braden Scale, daily comprehensive skin assessments, scheduled repositioning, use of appropriate support surfaces, moisture and nutrition management, and early escalation for high-risk patients. Ongoing staff education, multidisciplinary rounds, audit-feedback cycles, and leadership oversight supported sustained compliance. Pressure injury data were collected through incident reporting systems and annual prevalence audits.
Results:
Hospital-acquired pressure injury incidence decreased from 8.2 to 2.1 per 1,000 patient-days, representing a 74% reduction over 10 years. Advanced-stage (Stage 3 and 4) pressure injuries declined by 82%, with several units achieving prolonged periods of zero harm. Compliance with Skin Bundle elements improved from 68% to 95%, accompanied by a 30% improvement in staff competency scores.
Discussion: Sustained implementation of a Skin Bundle–driven pressure injury prevention strategy resulted in significant and durable improvements in patient outcomes at territory hospital. strong clinical leadership, continuous education, and outcome monitoring were key to achieving and maintaining excellence in pressure injury prevention