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Recommended Citation
Oppermann S, Witkofski H, Maszka T. A Picture Worth a Thousand Words for HAPI Prevention. Technological Innovations in Care Redesign and Delivery podium presentation at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.
Presentation Notes
Technological Innovations in Care Redesign and Delivery podium presentation at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.
Abstract
Introduction and Context
In 2024, a Wisconsin healthcare system prioritized the Patient Safety and Adverse Event Composite (PSI-90) as a key quality benchmark. One component, the PSI-03 Pressure Ulcer Rate, reflects a hospital’s ability to prevent hospital-acquired pressure injuries (HAPI). In the year prior to project implementation, a Milwaukee, Wisconsin, community hospital recorded 52 HAPIs—at least 10% of which were suspected to be present on admission (POA) but lacked proper documentation. Additionally, 5% were staged at level three or higher, adversely impacting PSI-03 HAPI outcome.
Implementation Strategy
In April 2024, a multidisciplinary team launched a technological initiative to improve POA wound documentation through nurse-driven bedside wound photography. The hospital provided tablets with Haiku, an Epic mobile app, allowing bedside staff to capture and upload wound images directly into the electronic health record. This initiative aimed to enhance documentation accuracy and reduce preventable HAPI incidents.
Outcomes and Impact
Since implementation, the site achieved nine consecutive months without PSI-03 HAPI incidents. Photographic documentation verified that at least two wounds were POA, preventing their misclassification as hospital-acquired. This nurse-driven change significantly improved the accuracy of quality reporting and strengthened risk mitigation efforts.
Insights
The use of real-time wound photography improved communication between care teams, provided objective documentation for clinical decision-making, and enabled earlier skin deterioration intervention. The innovation also helped establish a visual timeline of wound progression throughout a patient’s stay, enhancing both care continuity and accountability.
Implications
Mobile photography for POA wound documentation represents a scalable, nurse-driven strategy for improving pressure injury classification and patient safety. Continued use may reduce preventable penalties tied to PSI-90 scores while supporting clinical accuracy and enhanced patient safety through wound tracking across the care continuum.
Document Type
Oral/Podium Presentation
Publication Date
11-12-2025
A Picture Worth a Thousand Words for HAPI Prevention
Introduction and Context
In 2024, a Wisconsin healthcare system prioritized the Patient Safety and Adverse Event Composite (PSI-90) as a key quality benchmark. One component, the PSI-03 Pressure Ulcer Rate, reflects a hospital’s ability to prevent hospital-acquired pressure injuries (HAPI). In the year prior to project implementation, a Milwaukee, Wisconsin, community hospital recorded 52 HAPIs—at least 10% of which were suspected to be present on admission (POA) but lacked proper documentation. Additionally, 5% were staged at level three or higher, adversely impacting PSI-03 HAPI outcome.
Implementation Strategy
In April 2024, a multidisciplinary team launched a technological initiative to improve POA wound documentation through nurse-driven bedside wound photography. The hospital provided tablets with Haiku, an Epic mobile app, allowing bedside staff to capture and upload wound images directly into the electronic health record. This initiative aimed to enhance documentation accuracy and reduce preventable HAPI incidents.
Outcomes and Impact
Since implementation, the site achieved nine consecutive months without PSI-03 HAPI incidents. Photographic documentation verified that at least two wounds were POA, preventing their misclassification as hospital-acquired. This nurse-driven change significantly improved the accuracy of quality reporting and strengthened risk mitigation efforts.
Insights
The use of real-time wound photography improved communication between care teams, provided objective documentation for clinical decision-making, and enabled earlier skin deterioration intervention. The innovation also helped establish a visual timeline of wound progression throughout a patient’s stay, enhancing both care continuity and accountability.
Implications
Mobile photography for POA wound documentation represents a scalable, nurse-driven strategy for improving pressure injury classification and patient safety. Continued use may reduce preventable penalties tied to PSI-90 scores while supporting clinical accuracy and enhanced patient safety through wound tracking across the care continuum.
Affiliations
SL SouthShore