Measuring Pressure Injury Prevalence and Prevention Practices in Alberta Hospitals

This project, conducted in partnership with the former Neurosciences, Rehabilitation & Vision Strategic Clinical Network (NRV-SCN), leveraged Connect Care, to measure the prevalence of pressure injuries (PIs) and evaluate prevention practices in Alberta hospitals. The NRV-SCN and W21C teams collaborated through each project stage, with the teams co-developing the study design, reviewing 2,765 unique patient records from 127 units across seven hospitals, analyzing the data, and sharing the findings. Key results showed the overall prevalence of PIs in Alberta, variation in documentation practices, and how PI prevalence varies across hospitals. The project offered recommendations for policy changes, quality improvements, and better clinical practices to help reduce the impact of PIs in Alberta, highlighting what can be achieved by leveraging the diverse expertise among the collaborators.  

This study demonstrates the feasibility and utility of a province-wide, electronic audit approach using Connect Care to monitor PI prevalence and prevention practices in Alberta hospitals. By co-developing a digital alternative to the manual Pressure Injury Point Prevalence and Process Audit (PIPPPA), the project offered a scalable and cost-effective mechanism to assess patient safety, quality of care, and documentation practices without burdening frontline staff. 

A key impact lies in setting up an example of enabling the healthcare system in Alberta to integrate routinely collected electronic health record data into quality improvement and policy decision-making. The study findings will also be valuable as the foundational data to support the development of standardized provincial policies for PI prevention, documentation, and reporting.  

Further, the project highlighted critical documentation gaps, reinforcing the need for system-level interventions to optimize Connect Care functionality and clinical workflows. These findings inform efforts to enhance clinical practice consistency, reduce inter-facility variation, and improve health equity and patient outcomes across zones. 

Clinically, the study calls for greater uptake of validated prevention tools like the Braden Scale and increased use of PI Prevention (PIP) order sets. It underscores the need for continuous evaluations, targeted interventions, and evidence-informed policy changes. It also demonstrates how interdisciplinary collaboration—including operations, clinical experts, and research teams—can successfully implement system-wide audits that guide actionable improvements in hospital care quality. 

W21C co-developed the electronic audit tool and co-designed the data collection tool using REDCap, and trained staff to conduct audits across participating hospitals. We also co-developed the data analysis methods, and we were responsible for data preparation, statistical analysis, and drafting the final report.