| Sumario: | Significance & Background: Hospital-acquired pressure injuries (HAPIs) represent a significant clinical complication, imposing substantial costs and adverse outcomes for patients. Annually, approximately 2.5 million HAPIs are reported, often leading to prolonged hospital stays and increased healthcare expenditures. These injuries pose a considerable challenge for healthcare institutions but are largely preventable through adherence to evidence-based prevention strategies. HAPIs are particularly prevalent among high-risk populations, including oncology patients. The Medical Oncology unit failed to meet HAPI prevention targets for FY25. Comprehensive case reviews identified key areas for improvement, particularly related to compliance with the HAPI prevention bundle, with a specific focus on turning compliance. Addressing this required an "all hands-on deck" approach, emphasizing coordinated turn teams to alleviate pressure in at-risk patients and enhance adherence to repositioning protocols. Purpose: This project aimed to standardize the implementation of bi-hourly turning and repositioning for at-risk patients on the Medical Oncology unit to reduce the incidence of pressure injuries. Interventions: A dedicated turn team model was developed to achieve targeted reductions in HAPI incidence. Patients with a Braden Score below 19, who were non-ambulatory, or were identified by the charge nurse, were assigned to the turn team assignment. An EPIC-generated report facilitated identification of patients with a Braden score less than 19 for charge nurses. Registered nurses (RNs) and patient care technicians (PCTs) were paired and scheduled for turning assignments via printed assignment sheets distributed by unit secretaries. The assignment sheets also included documentation expectations and a "cheat sheet" for the charge nurses to make the assignments. Results: The intervention led to a significant improvement in both turning and documentation compliance. The number of HAPI events on the medical oncology unit decreased from five incidents in 2024 to two in 2025, with the latter occurring prior to the initiation of turn teams. Since the implementation of the turn teams in March 2025, no new HAPI cases have been reported. Discussion: The implemented interventions effectively enhanced compliance with pressure injury prevention protocols, particularly bi-hourly turning and documentation. The dedicated turn team model fostered shared responsibility among staff, reinforcing consistent patient repositioning practices. Additionally, this approach increased opportunities for skin assessment, thereby supporting early identification and management of pressure-related risks.
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