The prevalence of hospital-acquired pressure ulcers is decreasing in Tennessee; however cases still occur. Hospital-acquired pressure ulcers increase pain, duration of care, risk of secondary infection, and risk of mortality. In fact, the Institute for Healthcare Improvement reports that nearly 60,000 hospital patients die annually from complications of a hospital-acquired pressure ulcer. The burden of pressure ulcers is financial as well as clinical. The National Pressure Ulcer Advisory Panel states that pressure ulcer care approaches $11 billion annually, with individual pressure ulcer treatment costs ranging between $500 and $70,000. The Tennessee Center for Patient Safety supports hospital efforts to reduce hospital-acquired pressure ulcers through provision of evidence-based risk-screening and prevention strategies, focused education programs, and opportunities for peer-to-peer sharing of practice.


Institute for Healthcare Improvement (IHI) Resources:

IHI How-to Guide: Prevent Pressure Ulcers

Agency for Healthcare Research and Quality (AHRQ) Resources:

AHRQ Preventing Pressure Ulcers in Hospitals Toolkit

National Pressure Ulcer Advisory Panel Resources:

Pressure Ulcer Prevention Quick Reference Guide
International Pressure Ulcer Guidelines
Root Cause Analysis Tool
NPUAP Pressure Injury Stages

Additional Resources:

NDNQI Pressure Ulcer Training

Annals of Internal Medicine: "Pressure Ulcer Risk Assessment and Prevention: A Systematic Comparative Effectiveness Review"

HRET Resources:

HRET Pressure Injuries Change Package
HRET Pressure Injuries Top Ten Checklist
HRET Sacral Injuries Prevention Top Ten Checklist
HRET Pressure Injuries Webinars

HAPI Panel of Experts

Launched in 2019, the TCPS HAPI Panel of Experts is a group of wound care and quality improvement professionals that meets to discuss one HAPI-related question or challenge each month.  Key perspectives and recommendations are compiled into a report for distribution to other hospitals.  Please review the reports here.  To submit a question for the panel or be placed on a HAPI communications email list, please contact Rhonda Dickman at 615-401-7404.

Useful Websites:

The National Pressure Ulcer Advisory Panel (NPUAP) serves as the authoritative voice for improved patient outcomes in pressure ulcer prevention and treatment through public policy, education and research.

The Wound, Ostomy and Continence Nurses Society™ (WOCN®) is a professional nursing society, which supports its members by promoting educational, clinical, and research opportunities to advance the practice and guide the delivery of expert health care to individuals with wound, ostomy and continence concerns.


THA Pressure Injuries Contact

Rhonda Dickman
Clinical Quality Improvement Specialist