Business case

Business Case Proposal Problem Identification: Hospital-acquired pressure injuries (HAPIs) still occur on the medical-surgical unit, even though they are largely preventable. They harm patients causing more pain, raising the risk of infection, and lengthening hospital stays. They also create a financial burden: advanced-stage pressure injuries are not reimbursed by the Centers for Medicare & Medicaid Services (CMS) and are expensive to treat. Even a few cases on one unit can lead to significant unreimbursed costs. Because most prevention happens at the bedside, this problem is well suited to a unit-level intervention Current situation: Currently, Braden Scale assessments are completed on admission, and repositioning is recommended every two hours. However, reassessment and documentation practices are inconsistent, and there is limited auditing or real-time accountability. As a result, prevention measures are not always reliably implemented, allowing avoidable pressure injuries to occur. Evidence based: The proposed intervention is implementation of a standardized pressure injury prevention bundle that includes: Braden reassessment every shift Scheduled repositioning reminders in the electronic health record Skin inspection during bedside shift report Routine compliance audits with feedback Research supports that structured prevention bundles with monitoring significantly reduce HAPI rates. Impact: This intervention is expected to reduce pressure injury incidence, improve patient outcomes, and shorten length of stay. Financially, preventing even one advanced-stage pressure injury can offset implementation costs by avoiding treatment expenses and non-reimbursed complications. Studies demonstrate that prevention programs reduce injury rates and generate measurable cost savings at the unit level References: Padula, W. V., Black, J. M., Davidson, P. M., Kang, S. Y., & Pronovost, P. J. (2019). Adverse effects of hospital-acquired pressure ulcers on patients and hospitals. Journal of Patient Safety, 15(3), 192199.