K-Cards and Care Bundles: Using Visual Cues and Evidence-Based Practice to Decrease Hospital-Acquired Pressure Injuries

Hospital-acquired pressure injuries (HAPIs) are nursing-sensitive indicators that can lead to extended hospital stays, infection, and even death. A quality improvement project utilizing Kamishibai Cards (K-Cards) with HAPI prevention interventions was implemented at one hospital to determine if implementing K-Cards would decrease HAPI frequency counts. The project occurred on two adult units with two non-intervention units for comparison. K-Cards listing HAPI prevention interventions were placed outside each patient room as visual cues. HAPI frequency counts were collected and compared for 12 weeks before and after K-Card implementation. One project unit experienced a 66% reduction in HAPI frequency counts [n = 6 (pre), 2 (post)], while their comparison unit experienced a 200% increase [n = 0 (pre), 2 (post)]. The other project unit experienced a 15% reduction in HAPI frequency counts [n = 13 (pre), 11 (post)], while their comparison unit experienced no change [n = 2 (pre), 2 (post)]. The decrease in HAPI frequency counts post-K-Card implementation, with no changes or increases in the comparison units, indicates that K-Cards are a promising HAPI reduction strategy warranting further exploration. Further projects with modified K-Cards, longer implementation timeframes, and different settings are recommended to better assess K-Cards' impact on preventing HAPIs.