Other Titles
Rising Star Poster/Presentation
Abstract
This quality improvement project evaluated the effectiveness of implementing a standardized two-nurse admission skin assessment, supported by digital wound photography, to strengthen documentation accuracy and improve recognition of pressure injuries at a large tertiary medical center. Hospital-acquired pressure injuries (HAPIs) remain a serious safety and financial concern, and inconsistent, subjective admission skin assessments limit the ability to distinguish present-on-admission conditions from hospital-acquired injuries. Guided by the Plan-Do-Study-Act methodology, the intervention was implemented across five targeted units following staff education, workflow updates, and integration of secure, HIPAA-compliant wound photography. Data collection included electronic medical record audits, PSI-03 quality reports, learning management system completion data, and a post-intervention nursing survey. Pre-/post-comparisons using Fisher’s exact test showed a modest reduction in PSI-03 rates from 6.7% (11 events/164 patients) pre-intervention to 6.25% (1 event/16 patients) post-intervention, though the difference was not statistically significant (p = .68). Although the sample size after the intervention was small, the findings showed that using objective, time-stamped images led to better assessment reliability, stronger documentation integrity, and improved communication among professionals. These findings are consistent with the existing literature, which indicates that improvements in staging accuracy and assessment consistency often precede measurable reductions in outcomes. The project establishes a replicable, technology-enhanced plan that strengthens early skin assessment practices, reduces medico-legal liability, and supports more accurate PSI-03 classification. Ongoing monitoring and wider implementation of this integrated assessment model could enhance patient safety, promote consistent nursing practices, and support sustained reductions in reportable PSI-03 events.
Notes
Extensive reference list included as separate attached file.
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
Quality Improvement
Research Approach
Translational Research/Evidence-based Practice
Keywords:
Nursing Assessment, Risk Assessment, Medical Needs Assessment, Pressure Ulcers, Skin Care, Hospital Care, Hospital Nursing Staff, Digital Photography
Recommended Citation
Austin, Melody R., "Implementation of Wound Digital Photography During Admission Two-Nurse Skin Assessments" (2026). International Nursing Research Congress (INRC). 148.
https://www.sigmarepository.org/inrc/2026/posters_2026/148
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Invited Presentation
Acquisition
Proxy-submission
Date of Issue
2026-10-05
Implementation of Wound Digital Photography During Admission Two-Nurse Skin Assessments
Toronto, Ontario, Canada
This quality improvement project evaluated the effectiveness of implementing a standardized two-nurse admission skin assessment, supported by digital wound photography, to strengthen documentation accuracy and improve recognition of pressure injuries at a large tertiary medical center. Hospital-acquired pressure injuries (HAPIs) remain a serious safety and financial concern, and inconsistent, subjective admission skin assessments limit the ability to distinguish present-on-admission conditions from hospital-acquired injuries. Guided by the Plan-Do-Study-Act methodology, the intervention was implemented across five targeted units following staff education, workflow updates, and integration of secure, HIPAA-compliant wound photography. Data collection included electronic medical record audits, PSI-03 quality reports, learning management system completion data, and a post-intervention nursing survey. Pre-/post-comparisons using Fisher’s exact test showed a modest reduction in PSI-03 rates from 6.7% (11 events/164 patients) pre-intervention to 6.25% (1 event/16 patients) post-intervention, though the difference was not statistically significant (p = .68). Although the sample size after the intervention was small, the findings showed that using objective, time-stamped images led to better assessment reliability, stronger documentation integrity, and improved communication among professionals. These findings are consistent with the existing literature, which indicates that improvements in staging accuracy and assessment consistency often precede measurable reductions in outcomes. The project establishes a replicable, technology-enhanced plan that strengthens early skin assessment practices, reduces medico-legal liability, and supports more accurate PSI-03 classification. Ongoing monitoring and wider implementation of this integrated assessment model could enhance patient safety, promote consistent nursing practices, and support sustained reductions in reportable PSI-03 events.
Description
This quality improvement project evaluated the effectiveness of implementing a standardized two-nurse admission skin assessment supported by digital wound photography to improve documentation accuracy and early recognition of acquired community pressure injuries in a large tertiary medical center.