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The measured outcome was the HAPI incidence rate on the identified unit. This quality improvement project used Lewin's change theory as the framework. The PICOT clinical question was: \u2018How does implementing a PI prevention bundle and validating the knowledge, skills and attitudes of nurses on a medical surgical\/step-down unit result in an improvement in the HAPI rate and improve the knowledge of nurses over eight weeks compared to solely utilising the current PI hospital policy and online PI education tool?\u2019 For the eight weeks from October 2021 to November 2021, the pre-implementation HAPI incidence rate was 6.51%. Post-implementation, the HAPI incidence rate decreased by 5.5%, and knowledge scores increased by 13% (average test score pre-implementation was 75.8%). Limitations were nursing shortages due to the COVID-19 pandemic. Recommendations included implementing the intervention bundle and competency assessment in other units over an extended timeframe and with a larger sample of patients.<\/jats:p>","DOI":"10.12968\/jowc.2022.0234","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T11:00:33Z","timestamp":1773226833000},"source":"Crossref","is-referenced-by-count":0,"title":["Hospital-acquired pressure injury prevention: a quality improvement project"],"prefix":"10.12968","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7661-7144","authenticated-orcid":false,"given":"Charlene K","family":"Kayum","sequence":"first","affiliation":[{"name":"Acute Medical Center, Bronx, New York, US"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5130","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.asw.0000732748.56041.cf"},{"key":"e_1_3_2_2_2","unstructured":"Agency for Healthcare Research and Quality. 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