NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Name

Capella university

NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health

Prof. Name

Date

Implementing Evidence-Based Practice

Good afternoon, everyone. My name is _______, and today, I am sharing my poster on pressure ulcer prevention in healthcare. Pressure ulcers are still a problem in clinical practice because the protocol for preventing them is not followed as it should be. This presentation outlines an evidence-based plan for preventing them from decreasing their occurrence through risk tools, staff training, and infection prevention measures to promote patient safety and better patient care throughout the continuum. 

Background of the Clinical Problem

Pressure ulcers are injuries to the skin and underlying tissue due to unrelieved pressure and are most commonly experienced by immobile patients in acute and long-term care. Possible complications include infections, slow healing, and a higher risk of death. According to the literature, mortality from this condition is two to six times higher than from other diseases and leads to approximately 60,000 deaths due to complications every year (Borojeny et al., 2020). However, despite the improvements in the prevention protocols, there are still some deficiencies in practice: insufficient risk evaluation, irregular repositioning, and staff’s lack of knowledge about the topic. It has, thus, become paramount to bridge these gaps to improve patient results, lower costs, and provide quality care.

PICOT Question

The PICO(T) inquiry question for the clinical problem is as follows: In hospitalized patients at risk for pressure ulcers (P), does a comprehensive pressure ulcer prevention program, including staff education, frequent repositioning, and the use of specialized mattresses (I), reduce the incidence of pressure ulcers (O) within three months (T) compared to standard care (C)?  

PICOT Components  

Patients/Population: Admitted high-risk patients at the hospital 

Intervention: Multifaceted pressure ulcer prevention program

Comparing Variable: Standardized care

Outcome: Reduction of pressure injury incidents 

Time: Three months

Stakeholders Involved 

Moving to the next part of the poster, the major stakeholders are patients who will experience improved care, decreased pressure ulcers, and fewer complications. Nurses, nursing assistants, and wound care consultants are often first-line defenders who give advice and do preventive work in daily patient care. Physicians are critical in supporting the program through patient assessments and recommendations, while hospital administrators ensure resources and funding. Dietitians are responsible for nutrition, one of the most important aspects of wound healing (Donnelly et al., 2024).

Also important to patients’ mobility needs and recovery of physical function is to have individuals who practice physical therapy care to provide for their needs. The quality improvement staff will be charged with ensuring compliance with the results. These stakeholders will be important and must be consulted before the program is implemented for efficiency and a better outcome.

Action Plan for Implementation 

Recommended Practice Change 

The proposed practice change involves implementing a comprehensive pressure ulcer prevention program. This program includes awareness of pressure ulcer preventive measures and training all healthcare workers in preventing and managing pressure ulcers. It is also recommended that the Braden Scale risk assessment tools be implemented as often as possible. High-risk patients require repositioning every two hours, and pressure-relieving mattresses and cushions should be prescribed (Miguel et al., 2024). The proposed modification is designed to decrease pressure ulcers in hospitalized patients and guarantee the quality of care.

Timeline  

The timeline for implementing this plan is divided into several weeks. During the first two weeks, the prevalence and incidence of pressure ulcers will be determined, and high-risk individuals will be identified. The current state can, therefore, be examined and targeted with intervention to support our goals, as shown below. In week three, posters, handouts, and e-learning modules will be created, and the staff will be informed about the new prevention strategies. The prevention program will be in its complete functional form by week four, and a specialized mattress and cushion will be given to the respective patients. In weeks five to twelve, we will focus on staff compliance with the interventions, risk assessments, and pressure ulcer incidence to assess the program. Feedback will be given frequently to ensure changes are made where necessary.

Tools and Resources

The following major instruments will be used in the pressure ulcer prevention program. First, we will use risk assessment tools such as the Braden Scale to evaluate patients at a high risk of pressure ulcers (Miguel et al., 2024). Furthermore, pressure-relieving mattresses, cushions, and positioning devices will also be available to prevent pressure injury to the at-risk areas for long periods.

To ensure staff is knowledgeable about pressure ulcer prevention procedures, posters, handouts, and e-learning modules will be developed. In addition, compliance tracking forms and audit checklists will be used to track compliance with the prevention program. In contrast, data collection tools will be used to track pressure ulcer incidence in the future. Lastly, wound care specialists and teamwork with nurses, physicians, dietitians, physical therapists, and quality improvement staff for changes will be critical to the success and longevity of the program (Unaegbu, 2021).

Potential Barriers to Implementation 

However, several factors may hinder the successful accomplishment of the project. These include staff resistance to change, insufficient training on prevention protocols, and limited availability of specialized mattresses and cushions. Additionally, time constraints may limit frequent changes of position and risk evaluation, and weak administrative backing might lead to problems with funding and resources. Clear communication about the program’s benefits and expected outcomes will be essential to overcome these barriers. Training staff fully, offering enough resources, and adjusting workload expectations will meet staff needs. Leadership support and regular feedback are crucial in sustaining motivation and accountability toward pressure ulcer prevention (Penilla Lozano, 2021). Finally, engaging stakeholders in planning will promote buy-in and ensure alignment with organizational goals.  

Outcome Measures

The first assessment criterion for the evidence-based practice project is a decrease in the rates of pressure ulcers in hospitalized patients. Secondary measures include a higher level of prevention protocol adherence, increased staff awareness and self-efficacy for interventions, and better patient satisfaction. Pressure ulcer rates will be assessed by new incidences identified during the implementation period and documented in the patient’s medical records. Audits and observations will be conducted to monitor adherence to the interventions, such as repositioning schedules and pressure-relieving devices (Ramalho et al., 2022). Pre and post-training questionnaires will assess self-assessment of staff knowledge and confidence. Lastly, patient satisfaction concerning pressure ulcer prevention measures will be assessed using validated questionnaires.  

Quadruple Aim

These outcomes align with the Quadruple Aim of healthcare, including boosting patient outcomes, improving the patient experience, cost-effectiveness, and augmenting staff satisfaction (Rangachari, 2023). Pressure ulcers directly impact patient outcomes, so their prevention is beneficial. Overall efficacy is further seen by the benefits that patients have a positive experience due to evidence-based prevention. Furthermore, decreased pressure ulcers contribute to reduced utilization of additional treatment and length of stay, affecting healthcare costs (McEvoy et al., 2020). Education of the staff and organization of the protocols enhance the flow of work activities and provide confidence to the staff; hence, the health of the staff and work-life balance are improved. Altogether, the mentioned outcomes contribute to developing a sustainable model of excellence in patient care and organizational performance.

Evaluation of Evidence

The evidence supporting the need for a practice change highlights the effectiveness of comprehensive pressure ulcer prevention programs in improving patient outcomes. Miguel et al. (2024) confirm that staff training, the risk-assessment tool (Braden Scale), repositioning, and support surfaces such as pressure-relieving devices help prevent pressure ulcers. The review also emphasizes the appropriateness of these strategies from the socio-economic perspective, thus minimizing treatment costs and hospitalization. The evidence highlights the need for complex interventions to help detect such patients early and avoid adverse outcomes.

To find the sources of information used in this study, databases such as PubMed, CINAHL, and the Cochrane Library were used as they offered several peer-reviewed articles and systematic reviews published over the last five years. The following keywords were used specifically for the study: pressure ulcer prevention, hospitalized patients, evidence-based interventions, risk assessment tools, and cost-effectiveness. Boolean operators were used to obtain a set of articles relevant to the topic, and filters were used to identify the best possible evidence, including RCTs, meta-analysis and guidelines.  

Summary of the Findings 

Given the sound methodological framework, the results obtained from the evidence sources are highly relevant and of high quality. The interventions in the study are multiple and always demonstrate the effects of multicomponent interventions in reducing pressure ulcers (Miguel et al., 2024). However, some limitations include the irregularity of the selected programs running in different healthcare settings depending on the sociopolitical system and some barriers, such as staff compliance. There is a strong rationale supporting the suggested practice change, which has definite implications for improving patient satisfaction, services, effectiveness, and reducing expenses. 

References

Borojeny, L. A., Albatineh, A. N., Dehkordi, A. H., & Gheshlagh, R. G. (2020). The incidence of pressure ulcers and its associations in different wards of the hospital: A systematic review and meta-analysis. International Journal of Preventive Medicine, 11(171). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7716611/

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Donnelly, H. R., Clarke, E. D., Collins, C. E., & Tehan, P. E. (2024). ‘Nutrition has everything to do with wound healing’—Health professionals’ perceptions of assessment and management of nutrition in individuals with diabetes‐related foot ulceration. International Wound Journal, 21(5), e14898. https://doi.org/10.1111/iwj.14898

McEvoy, N., Avsar, P., Patton, D., Curley, G., Kearney, C. J., & Moore, Z. (2020). The economic impact of pressure ulcers among patients in intensive care units. A systematic review. Journal of Tissue Viability, 30(2). https://doi.org/10.1016/j.jtv.2020.12.004 

Miguel, P., ernandes Moreira, I. F., Ferreira, L., Santos, M. S., & Ramos, R. C. (2024). Pressure ulcers/injuries prevention in emergency services: A scoping review. Journal of Tissue Viability, 33(4). https://doi.org/10.1016/j.jtv.2024.07.011

Penilla Lozano, K. D. (2021). HAPI prevention bundle: An initiative to prevent hospital-acquired pressure injuries. USF Scholarship: A Digital Repository @ Gleeson Library | Geschke Center. https://repository.usfca.edu/capstone/1291

Ramalho, A. de O., Santiago, L. M., Meira, L., Marin, A., de Oliveira, L. B., & Püschel, V. A. de A. (2022). Pressure injury prevention in adult critically ill patients: Best practice implementation project. JBI Evidence Implementation, 21(3), 218–228. https://doi.org/10.1097/xeb.0000000000000352

Rangachari, P. (2023). The untapped potential of the quadruple aim of primary care to foster a culture of health. International Journal of General Medicine, 16, 2237–2243. https://doi.org/10.2147/IJGM.S416367 

NURS FPX 6011 Assessment 3 Implementing Evidence-Based Practice

Unaegbu, T. (2021). Wound care management and documentation non-compliance in prevention and care of wounds. [Doctoral project, University of St Augustine for Health Sciences]. SOAR @ USA: Student Scholarly Projects Collection. https://doi.org/10.46409/sr.XPUU8046