Bedside nurses misdiagnosed 71.3% of hospital-acquired pressure injuries (HAPIs) in a 2022 review. Standardizing the electronic medical record (EMR) for real-time validation by specialized WOC nurses corrected these errors, demonstrating that expert verification is vital to prevent false positives, preserve data integrity, and protect hospital reimbursement. 

In collaboration with IT and nursing informatics, this quality improvement project transitioned Hospital-Acquired Pressure Injury (HAPI) validation from paper to electronic medical records (EMRs) via WOC nurses, establishing the EMR as the single accurate source for extracting regulatory reporting data. This expert electronic validation significantly improved reporting accuracy, reduced time due to manuel entry of reported HAPIs, prevented unnecessary treatments, and built a streamlined system that saved each of the five facilities $40,000. 

This quality improvement project at large hostipal used the PDCA cycle to enhance registered nurses' pressure injury (PI) knowledge through workshops and WOC nurse shadow days. The initiative significantly improved clinical judgment in differentiating PIs from other skin conditions, resulting in a 61.43% decrease in the HAPI rate. 

This case series demonstrates that instillation-enhanced negative pressure wound therapy with instillation and dwell-time (NPWTi-d) effectively managed complex full-thickness wounds. Across critical illness, necrotizing fasciitis, and stage 4 pressure injuries, the therapy optimized wound beds, facilitated debridement, reduced wound volumes, and prepared tissue for definitive healing. 

This performance improvement project implemented a multi-layer foam dressing approach to offload ears from medical devices like nasal cannulas. The intervention achieved 100% nursing compliance and resulted in a 76.50% decrease in medical device-related pressure injuries (MDRPIs) across the unit.