Improving Nurse Confidence in Pressure Injury Prevention: A Simulation and Escape Room Educational Intervention

Alison Appleman — Mon, 20 Apr 2026 00:00:00 +0000

Hospital-acquired pressure injuries (HAPIs) continue to affect millions of patients in the United States and are associated with significant physical, emotional, and financial consequences (Are we ready for this change?, 2022; Rubin, 2018). Nurses are central to prevention efforts, yet gaps in confidence and knowledge remain (Ebi, Hirko, & Mijena, 2019; Fletcher, 2019).

This quality improvement project describes a two-hour educational session combining a brief lecture, hands-on simulation, and an escape room activity to reinforce learning. Eight registered nurses participated. Pre- and post-intervention surveys showed an increase in confidence scores from 32 to 44 out of 50. Participants reported that interactive components, particularly the escape room, were most helpful.

These findings suggest that incorporating active learning strategies into nursing education improves confidence in pressure injury prevention and care (Cant & Cooper, 2017; Gutiérrez-Puertas et al., 2020; Sarage, O’Neill, & Eaton, 2021).

International journal of Nursing Didactics

Improving Nurse Confidence in Pressure Injury Prevention: A Simulation and Escape Room Educational Intervention