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Hospital-Acquired Pressure Injuries: Strategies for Prevention

May 23, 2023

Editor's Note: How can facilities lower their hospital-acquired pressure injury (HAPI) rates? In this interview, Kelly McFee, DNP, FNP-C, CWS, CWCN-AP, FACCWS, DAPWCA discusses setting up a pressure injury prevention program at her facility with a focus on multidisciplinary efforts, along with resources that helped move this initiative along.

Hospital-Acquired Pressure Injuries: Strategies for Prevention from HMP on Vimeo.


My name is Kelly McFee. I am a nurse practitioner in wound care and a director of wound care for mosaic life care in northwest Missouri.

1. Can you briefly talk about the different strategies for HAPI prevention?

So, there's several different strategies that we can implement in a hospital setting for prevention of hospital-acquired pressure injuries. I like to use a multidisciplinary approach in this process because it's not just a nurse’s task. I'm a nurse, and I've been a nurse for a long time.

I don't want nurses to feel like it's just a nursing task. This is a task that we can involve a lot of different disciplines in and kind of “rally the troops” so that we're all invested in pressure injury prevention.

In our facility, this was a huge undertaking for pressure injury prevention and setting up our protocols and our program for this [initiative]. But we can use a lot of different resources. Again AHRQ has a toolkit that's a huge wealth of information that walks an organization through setting up pressure injury prevention interventions, as well as using information from NPIAP.

We have implemented prophylactic dressings. Our nurses have had a wealth of education. I mean this was a massive over year undertaking to get our program put in place.

But it's not something that just stops once you've started it. We have to make sure that we go back and re-educate, and that we're re-educating all the correct people in this process.

2. What are some of the pros and cons of these different strategies?

Certainly the pros are that you get to see the fruits of your labor pretty quickly as you see the hospital-acquired pressure injury rate [at your facility] starts to drop, which is nice. That's positive feedback for everybody who's involved in that process. There's a lot of work that goes into it. Being able to see your efforts come out in the end result. And then you got to make sure you share those results with everybody, because if you have nursing staff or, you know, dietary, everybody's working together but they don't ever know what they've done.

It's very important to make sure that you share that information with them. And then of course, I don't want to say it's a con, but I think we all know that there's a lot involved in this process and putting together these programs. So, it takes a lot of dedication, and it takes a lot of time. And then, as soon as you get your program in place, it's time to go back and start re-educating. And that's something that we do on a regular basis. You know, we know that nursing and health care has had quite a bit of turnover as a result of COVID. So, we have to go back through and make sure that we're re-educating and making sure that everybody still understands the process, whether they're new or they've been with us for a while. And so that does take a lot of time and effort.

About the Speaker
Kelly McFee, DNP, is a Board-Certified Family Nurse Practitioner, Certified Wound Specialist and Advanced Practice Certified Wound Care Nurse who has been practicing Wound Care and Hyperbaric Medicine in Northwest Missouri. She received a BSN from Missouri Western State University, MSN from the University of Missouri – Kansas City, and DNP from the University of South Alabama.

Kelly serves as the Director of Wound Care for Mosaic Life Care and practices wound care both in the acute care and outpatient settings. She is an active member of the American Professional Wound Care Association, Association of Advancement of Wound Care, and the Wound, Ostomy and Continence Nurses Society. She serves on the Board of Directors for the American College of Clinical Wound Specialists and will be serving the college as the Chair-elect in 2022. She is also a member of the Prophylactic Dressing Standards Initiative, a joint collaboration between the NPIAP and EPUAP.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, HMP Global, its affiliates, or subsidiary companies.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, HMP Global, its affiliates, or subsidiary companies.