School of Nursing


Doctor of Nursing Practice (DNP)


Rachel Joseph


pressure injury, intensive care unit, hospital-acquired pressure injuries, pressure ulcer, RAPS-ICU




Aim: To use an ICU-specific pressure injury (PI) risk assessment scale to promptly identify the risk for PIs in critically ill patients and promptly implement the appropriate PI prevention interventions to decrease the incidence rate of pressure injuries over 11 weeks.

Background: The risk of developing PIs is 3.8 times higher in the ICU patients than in other patient populations. The state of illness and or treatments increase their odds of developing hospital-acquired pressure injuries (HAPIs). The Braden scale currently in use may not identify the risk early enough to provide preventive interventions. An ICU-specific tool is needed to screen ICU patient population.

Methods: A quasi-experimental method was used for this evidence-based project. A total of 268 (56.9%) out of the 471 patients admitted to the ICU were screened using the risk assessment pressure ulcer scale (RAPS)-ICU tool, and the intervention was placing the patients on an air fluidized bed.

Results: The incidence of pressure injury during the 11 weeks after implementation was 1.49% of the 268 screened patients. The incidence of HAPI for all the patients admitted during the pre-implementation weeks was 5.53% (23 out of 416). The incidence of HAPI post implementation was 1.49% (4 out of 268).

Conclusion: The incidence of HAPI was lower after the implementation of an air fluidized bed based on the scores of an ICU-specific tool.

Implication for practice: using the appropriate tool to screen and identify the patient at increased risk for HAPIs in the ICU and providing appropriate interventions could help decrease the incidence of PIs in this patient population.

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Nursing Commons