Date of Conferral



Doctor of Nursing Practice (DNP)




Margaret Harvey


Hospital-acquired pressure injuries (HAPIs) affect approximately 2.5 million patients in the

United States, annually. Prevention requires surgical intensive care unit (SICU) nursing staff to

effectively use evidence-based risk assessment measures to appropriately identify patients at risk

for developing HAPIs and to prevent poor patient outcomes. The Braden Scale risk assessment

tool has demonstrated reliability and validity in the prediction and assessment of patients at risk

for the development of HAPIs. The purpose of this Doctor of Nursing Practice (DNP) project

was to improve nurses’ knowledge of the appropriate use of the Braden Scale risk assessment

tool in the SICU of an urban acute care hospital in a Southern state, to identify critically ill

patients that are at risk for developing HAPIs. The design and implementation of this educational

program were guided by the Lean model and the Lewin’s change theory. The practice-focused

question focused on determining improvements in the knowledge of the nurses in a SICU

following an education program, coupled with an enhancement to the visualization of the Braden

Scale items using a teaching sheet. Forty SICU nurses participated in the educational program

and completed the pre-test and post-test to evaluate education. The results showed learner

knowledge gain with increases in mean correct score on 3 items on pressure injury prevention (M

= 36.3; Range 63.2% to 90.8%) and 3 items on effective use of the Braden Scale (M = 33.3;

Range 57.5% to 90.8%). Improving the nurses’ knowledge and confidence levels can expedite

the assessment and appropriate prediction of at-risk patients and prevent the development of

HAPIs and other health-related complications associated with HAPIs, which can emphatically

impact social change.

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Nursing Commons