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Getting to the bottom of HAPI: Hospital Acquired Pressure Injuries

22 Aug 2016, by Informa Insights


Michelle Barakat-Johnson from the Sydney Local Health District (SLHD) joined us to discuss the positive changes needed to address the problems with Hospital Acquired Pressure Injuries (HAPI). As a preview to her presentation at next week’s Falls, Fractures and Pressure Injuries Conference, Michelle highlighted the benefits of a systematic approach to preventative strategies and to sharing research with colleagues and clinicians to ensure effective and sustainable outcomes.  

INFORMA: What is a highlight of your experience working to reduce falls and pressure injuries? Is there a particular accomplishment you’re particularly proud of?

hospital-834157_1920Michelle: I love working with clinicians to make a positive change to patient care and I have always been passionate about core fundamental nursing care.  Pressure injuries, falls and nutrition fit into core fundamental nursing, the part of nursing that was drummed into me when I first started. I remember when we did rounds and made every patient comfortable.  This meant helping patients with the simple everyday things we take for granted such as brushing teeth, turning and massaging their back, giving them a bed bath, ensuring they have had adequate food etc, big for them but simple for us. I feel really lucky to have the opportunity in my current role where I am taking a methodical approach using the learnings from my PHD supervisors and the support of the district executive to make a positive change especially to core fundamental nursing practice.  The highlight for me so far has been learning how to address a significant problem, one that I am passionate about, in a systematic way using and sharing my research skills with my colleagues and clinicians to ensure an effective and sustainable outcome.  

I’m particularly proud of having already reduced the number of Hospital Acquired Pressure Injuries by 40% in one of the large hospitals in our district just by assessing the accuracy of incident reporting. I’m extremely confident that at the end of the research the approaches that would have been adopted across the district will have a significant and sustained reduction. 

INFORMA: Is there a specific preventative strategy that has proven to help reduce Hospital Acquired Pressure Injuries (HAPI) that you would suggest as particularly effective?

Michelle: Pressure injuries are not universally preventable and for ones that are, well there are international guidelines that have strong solid evidence highlighting preventative intervention strategies. We also know that intervention bundles can be effective and that executive support is essential.  However, it’s more than that, it’s looking at the underlying mechanisms as to why hospital acquired pressure injuries still occur despite local policy and international guidelines.  Developing an implementation strategy based on research findings and putting it into practice so that it is successful and sustainable is the challenge.

INFORMA: Your session will look at an increase in Hospital Acquired Pressure Injuries (HAPI) at the Sydney Local Health District and how you’re working to combat this – without giving too much away, what is an important takeaway attendees can expect from the session?

Michelle: Combating a significant problem is a not ‘one size fits all solution’. We are still trying very hard to work out the best way to address the problem we have with HAPI. We have so far investigated the relationship between pressure injury development, nursing practice, nurse, patient and carer knowledge, reporting systems and documentation. So whilst there is strong solid evidence on preventative strategies especially of HAPI it’s apparent that organizational practices, culture and systems can negatively affect the success and sustainability of evidence into practice or adhering to local policy guidelines. 

INFORMA: This is your first time speaking at the conference – What are you most looking forward to at the conference? Are there any presentations at the Falls, Fractures and Pressure Injuries Management Conference that you are particularly looking forward to?

Michelle: I always find that after conferences I have so much information to take way not just from the presenters but equally from the delegates. I’m always really interested in what clinicians and researchers are doing so I am really looking forward to collaborating with clinicians and learning about their current work and activities in hospitals and across districts.  With regard to the presentation, as my work focuses on patient care and system barriers, I’m particularly interested in Kerrie Coleman’s presentation on what went wrong in a patient’s journey. I believe if we can reflect on our own practices learn from mistakes and understand barriers, difficulties and gaps it will bring us closer to providing best patient care.

Join Michelle at our Annual Falls, Fractures & Pressure Injuries Conference as it heads to Brisbane this year featuring over 22 expert speakers providing presentations, streams, case studies and research into fall prevention and management.

To access the approved presentations from the conference, visit

Presentations will be loaded throughout the course of the conference and will be available to share with colleagues.



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