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HAPI Prevention Strategies

Oct 4, 2025

Overview

This lecture covers strategies to prevent hospital-acquired pressure injuries (HAPIs), focusing on patient positioning, skin care, and use of preventative measures.

Prevention Strategies

  • Keep the head of the bed at 30° or less to decrease pressure.
  • Elevate the patient's heels to reduce friction and shear.
  • Encourage and assist with patient ambulation whenever possible.
  • Help patients get out of bed for meals and regular walks.
  • Perform daily skin assessments, focusing on bony prominences.
  • Apply preventative dressings, such as bordered foams, to high-risk areas.
  • Use protective dressings under medical devices like nasal cannulas and catheters.

Hygiene and Moisture Management

  • Keep the patient clean and dry to prevent skin breakdown.
  • Use toileting schedules and external collection devices for incontinence.
  • Check incontinent patients regularly to ensure cleanliness.
  • Avoid briefs, as they trap moisture against the skin.

Positioning and Movement

  • Use repositioning devices or sheets to prevent friction and shear when moving patients.
  • Reposition patients at least every two hours in bed and every hour in a chair.
  • Check that no devices, cords, or pads are underneath the patient during repositioning.
  • Ensure linens are smooth and free of wrinkles to reduce pressure points.

Nutrition

  • Ensure the patient maintains proper nutrition to support skin health and prevent injury.

Key Terms & Definitions

  • HAPI (Hospital-Acquired Pressure Injury) — An injury to skin or underlying tissue caused by prolonged pressure, often occurring in hospitalized patients.
  • Friction — Skin damage caused by rubbing against a surface.
  • Shear — Skin injury from layers of tissue sliding over each other.

Action Items / Next Steps

  • Assess patient skin daily, focusing on bony areas.
  • Follow scheduled repositioning routines.
  • Promote patient mobility and proper hygiene.
  • Review related materials or flashcards for more information.