Reduction in Pressure Injuries Following Implementation of a Position Clock and Reinforcement of Pressure Injury Prevention Practices: A Quality Improvement Project

Background Pressure injuries remain a significant indicator of patient safety and quality of nursing care. Hospital-acquired pressure injuries (HAPIs) increase morbidity, length of hospital stay, and healthcare costs. Consistent repositioning and adherence to preventive nursing practices are essential to reduce their occurrence. Aim To evaluate the impact of implementing a position clock along with reinforcement of pressure injury prevention practices on the incidence and severity of pressure injuries in hospitalized patients. Methods A retrospective quality improvement project was conducted in a tertiary care hospital comparing pressure injury data between 2022 (pre-intervention) and 2023-2024 (post-intervention). Interventions included implementation of a position clock to improve timely patient repositioning, staff education on pressure injury prevention, reinforcement of regular skin assessment, moisture management, nutritional support, and use of pressure-relieving surfaces for high-risk patients. Pressure injuries were classified according to standard staging criteria. Results Total pressure injuries reduced from 16 cases in 2022 to 1 case in 2024, demonstrating a 93.75% reduction. Device-associated pressure injuries decreased from 11 to 1 case, while hospital-acquired pressure injuries decreased from 5 to 0 cases. Stage 2 injuries reduced from 12 cases to 0 cases. No Stage 2, Stage 3 or Stage 4 pressure injuries were reported in 2024. Conclusion Implementation of a position clock combined with reinforcement of standard pressure injury prevention measures significantly reduced the incidence and severity of pressure injuries. Simple, low-cost nursing interventions can substantially improve patient safety outcomes.