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To assess a quality improvement project using alternating pressure air mattresses' impact on reducing full‐thickness pressure injuries by enhancing setting accuracy and device utilization. We retrospectively evaluated adult acute care unit patients with inclusion criteria (Braden scores ≤12 or existing full‐thickness pressure injuries) between May 2020 and August 2023. A wound team attempted to enhance the accuracy, utilization and effectiveness of alternating pressure air mattress implementation. The implementation outcomes were setting accuracy and accurate utilization rates. The clinical outcome was the full‐thickness pressure injury proportion. Utilization and allocation gaps were also calculated. The setting accuracy and accurate utilization rates increased (0.59 to 0.88 and 0.15 to 0.37, respectively). The full‐thickness pressure injury proportion decreased (0.17 to 0.06), with a strong negative correlation coefficient (−0.789) (p < 0.001) with accurate utilization rates. The full‐thickness pressure injury proportion declined faster during the project's complete phase than the partial phase (−0.0046 vs. −0.0016; p < 0.05). The utilization gap narrowed (99 to 60); however, the allocation gap increased (1 to 13), suggesting increased alternating pressure air mattress usage among ineligible patients. Targeting high‐risk patients for alternating pressure air mattress utilization and ensuring correct settings, both performed by a dedicated team, substantially reduces the full‐thickness pressure injury incidence. [ABSTRACT FROM AUTHOR]