Your resource for HQIC highlights and learning opportunities | March 2021
March Issue: HAPI
March is Pressure Injury Prevention Month
COVID-19 patients with acute respiratory distress syndrome (ARDS) often require prone positioning for long periods of time to improve respiratory status, increasing the risk of hospital acquired pressure injury (HAPI). Pressure injury (PI) reduction tips include pre-prone positioning interventions, such as skin assessment, pressure redistribution devices and/or surfaces, taped endotracheal tubes, liquid film-forming protective/prophylactic dressings, and lubricating and taping shut the patient’s eyes. Prone positioning interventions include using the swimmer’s position, repositioning every two hours, and keeping the skin clean.1

Before attending the Health Services Advisory Group (HSAG) Hospital Quality Improvement Contract (HQIC) HAPI webinar on March 18, we encourage you to review the strategies to implement for all patients at risk of PI, found in the HAPI Roadmap to Success in The Flash section below.
The Flash: Resources
HAPI Roadmap to Success
Use the HAPI Roadmap to Success, developed by HSAG HQIC, to revisit the evidence-based practices and strategies to effectively prevent PI. The roadmap includes tools and resources for each step of your HAPI prevention journey, including:
  • Conducting a risk assessment and skin check.
  • Limiting patient’s skin exposure to moisture.
  • Optimizing nutrition.
  • Reducing pressure, friction, and shear and optimizing mobility.
  • Standardizing staff education and HAPI care competencies.
  • Developing and implementing your HAPI quality improvement program.
National Pressure Injury Advisory Panel (NPIAP) Pressure Injury Prevention (PIP) Tips for Prone Positioning
The NPIAP offers a poster on PI preventions and tips for prone positioning.
Centers for Disease Control and Prevention (CDC) Comprehensive Hospital Preparedness Checklist for for COVID-19
This checklist covers a structure for planning and decision making, and elements for development of a written COVID-19 plan. HSAG HQIC recommends that, at minimum, your facility has the elements of this checklist in place. 
HSAG HQIC Partner Resource:
Addressing Vaccine Hesitancy Video
CommonSpirit identified vaccine hesitancy with their staff, spurring development of this short and moving video: Vaccine, Hope, and Humankindness.
Critical Communication
Check your calendars for onboarding appointments, where we will review the HSAG HQIC partnership, ensure that crucial documents are submitted, and discuss how to best align HSAG HQIC support with your facility's priorities. If you are unsure of when your onboarding appointment is scheduled, please email or contact your HSAG HQIC quality advisor.
Events and Education
HAPI Prevention for Patients and Staff During the Era of COVID-19
Thursday, March 18, 2021
1–2 p.m. ET (12 noon CT, 11 a.m. MT, 10 a.m. PT)
Learning Objectives
  • Identify skin manifestations of COVID-19 in the differential diagnosis of a suspected PI.
  • Adapt the HAPI risk assessment for patients with COVID-19.
  • List specific challenges that heighten the risk of PIs in patients with acute respiratory distress Syndrome (ARDS) due to COVID-19.
  • Propose one strategy or product that may reduce PIs associated with positioning of patients with COVID-19.
  • Delineate specific interventions that may be implemented to prevent PIs due to prolonged use of N95 masks.

Virginia Capasso, PhD, CNP, ACNS-BC, CWS, FACCWS
An advanced practice nurse for wound healing, including pressure injury prevention and treatment, Dr. Capasso is a nurse scientist at Munn Center for Nursing Research at Massachusetts General Hospital (MGH). She is an instructor in surgery at Harvard Medical School and co-founder of the MGH Wound Care Center.
NHSN—Acute Care Mapping and Leveraging the TAP Strategy
Tuesday, March 23, 2021
2–3 p.m. ET (1 p.m. CT, 12 noon MT, 11 a.m. PT)
In this webinar, hear from experts at the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) division and discover how to leverage the Targeted Assessment for Prevention (TAP) strategy for your organization.

Learning Objectives
  • Utilize NHSN mapping guidance to determine appropriate unit acuity levels and make necessary changes within the application.
  • Analyze units within NHSN and identify those with the most opportunity for improvement by healthcare-associated infection (HAI).
  • Determine the cumulative attributable difference necessary to achieve value-based purchasing goals.
Code Lavender: Caring for the Caregiver
Thursday, April 1, 2021
2–3 p.m. ET (1 p.m. CT, 12 noon MT, 11 a.m. PT)
Featuring Rabbi Susan Stone, Cleveland Clinic Foundation.
It Figures
HSAG HQIC anticipates the release of the performance dashboard on its secure web-portal, the Quality Improvement Innovation Portal (QIIP), in March 2021. Please complete your QIIP Administrator form as soon as possible so you don’t miss accessing this data analytics tool upon release.
1Team, V., Team, L., and Weller, C. D. (2020). Pressure injury prevention in COVID-19 patients with acute respiratory distress syndrome, Front Med (Lausanne), 7:558696. Retrieved from
This material was prepared by Health Services Advisory Group (HSAG) Hospital Quality Improvement Contractor (HQIC), under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. XS-HQIC-XT-03022021-01