The 'HAPI' project five years on: Incidence and prevalence of Hospital-Acquired Pressure Injuries in one local health district in Australia

Aim: From 2015 to 2018, the 'Hospital-Acquired Pressure Injury (HAPI)' project was implemented in one local health district in Australia and utilised an implementation science approach to address rising pressure injury (PI) incidence and prevalence rates. This paper aims to examine whether the project was successful in sustaining low PI incidence and prevalence rates over the five-years following implementation (spanning the 2018/2019 to 2022/2023 financial years and the 2019-2023 calendar years).

Materials and methods: A retrospective cohort study was conducted involving a comprehensive analysis of HAPI incidence, prevalence, and hospital-acquired complication (HAC) data spanning 5 years (incidence and HAC: 2018/2019 to 2022/2023 financial years; prevalence: January 2019 to December 2023 calendar years) post-implementation of the HAPI project.

Results: Since 2018/2019, incidence of HAPIs decreased by 32.6 % (30.7 HAPI per 10,000 episodes of care in 2018/2019 vs 20.7 HAPI per 10,000 episodes of care in 2022/2023 financial year), prevalence remained stable from 1.1 % to 1.27 % (2019 vs 2023 calendar year), and HAC pressure injuries (stage III, IV, suspected deep tissue, unspecified or unstageable) declined by 27.3 % (2.2 HAPI per 10,000 episodes of care in 2018/2019 vs 1.6 HAPI per 10,000 episodes of care in 2022/2023 financial year).

Conclusion: The HAPI project has successfully maintained a low incidence and prevalence rate of HAPI, over 5 years following implementation. This achievement highlights the benefits of utilising an implementation science approach to implementing a multi-faceted intervention in a complex healthcare setting to ensure sustainability beyond the project phase.