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Increasing Competence in Pressure Injury Prevention Using Competency-Based Education in Adult Intensive Care Unit

Aquino, Carla DNP, RN; Owen, Amanda BSN, RN, CWCN; Predicce, Ashley BSN, RN; Poe, Stephanie DNP, RN; Kozachik, Sharon PhD, RN, FAAN

doi: 10.1097/NCQ.0000000000000388

Background: There is a significant focus on pressure injury prevention to promote better patient outcomes and control health care cost.

Local Problem: In 2016, the institution's pressure injury quarterly prevalence survey showed that two-thirds of the patients surveyed who developed unit-acquired pressure injury stage 2 and greater were in the adult intensive care units.

Methods: The quality improvement project used a pre- and postintervention design.

Interventions: The adult medical intensive care unit (MICU) executed a competency-based education project to increase staff implementation of pressure injury prevention.

Results: Following initiation of competency-based education, staff documentation of pressure injury prevention implementation increased, and unit-acquired pressure injury stage 2 and greater rates were reduced.

Conclusions: The use of a competency-based education program may be effective in increasing pressure injury prevention in the intensive care unit.

Departments of Nursing Administration (Dr Aquino) and Medical Nursing Administration (Ms Owen) and Medical Intensive Care Unit (Ms Predicce), The Johns Hopkins Hospital, Baltimore, Maryland; Department of Nursing Administration, The Johns Hopkins Hospital, The Johns Hopkins Health System, Baltimore, Maryland (Dr Poe); and The Johns Hopkins School of Nursing, Baltimore, Maryland (Dr Kozachik).

Correspondence: Carla Aquino, DNP, RN, Nursing Clinical Quality, The Johns Hopkins Hospital, 600 Wolfe St, Baltimore, MD 21287 (

The authors declare no conflicts of interest.

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Accepted for publication: December 9, 2018

Published ahead of print: February 25, 2019

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