NURS FPX 6025 Assessment 3 Practicum and Scholarly Article

Name

Capella university

NURS-FPX 6025 MSN Practicum

Prof. Name

Date

Practicum and Scholarly Article

This assessment reviews a peer-reviewed article examining the impact of nursing pressure injury (PI) prevention practices on reducing PI incidence in adult patients. Gillespie et al. (2021) investigate whether repositioning schedules effectively prevent PIs by applying the PICO framework—Population, Intervention, Comparison, Outcome. My practicum focuses on managing elderly patients with pressure injuries in critical care by implementing a PI care bundle guided by the PICOT approach to reduce PI rates.

Summary of Evidence-Based Journal Article

The article by Gillespie et al. (2021), titled “Repositioning for pressure injury prevention in adults: An abridged Cochrane systematic review and meta-analysis,” evaluates how different repositioning strategies affect the occurrence of PIs in adult critical care patients. Clinical guidelines recommend repositioning to redistribute pressure and prevent tissue ischemia, which leads to pressure injuries. The study reviews various repositioning intervals (e.g., every 2 hours vs. 4 hours) and body inclinations (side-lying, upright), assessing both patient outcomes and cost-effectiveness.

Repositioning aims to reduce pressure duration and intensity to minimize tissue hypoxia, thereby lowering PI risk. Gillespie et al. analyzed eight trials involving 3,941 adult patients in critical care. They found the following:

Trial Focus	Number of Participants	Outcome Metrics	Results Summary	Cost Assessment (Daily)
2- to 4-hour repositioning	1,074	Risk ratio of PI	Risk ratio = 1.06 (no significant difference)	\$11.05 (3-hour) vs. \$16.74 (4-hour)
30- to 90-degree body incline	252	Threat ratio of PI	Threat ratio = 0.62 (reduced PI risk)	N/A
Economic evaluations by nurses	–	Cost-effectiveness	Longer intervals less costly, comparable outcomes	As above

Using the PICO method, the study confirms that tailored repositioning schedules, integrated into a PI prevention bundle, can reduce PI incidence and inform clinical guidelines for patient care.

Discussion on Article with a Peer

The article by Gillespie et al. (2021), published in the International Journal of Nursing Studies, provides critical insights into PI prevention through nursing practices. It supports the use of repositioning schedules within PI prevention bundles, demonstrating that a 2-hour repositioning interval leads to better patient outcomes and reduced PI rates compared to longer intervals. The application of the PICO framework in this research highlights the benefits of evidence-based interventions that are both clinically effective and cost-efficient.

In discussions with a peer, we explored how socioeconomic barriers, such as limited healthcare access and transportation challenges, can impede patients’ ability to manage PI effectively. Therefore, cost-effective, easy-to-implement interventions like repositioning and patient education are vital in delivering quality PI care.

Our dialogue also incorporated findings from Wan et al. (2023), who reviewed barriers and facilitators in executing PI prevention bundles in acute care settings. Their research emphasizes the importance of involving both healthcare staff and patients to enhance guideline adherence. Additionally, Alshahrani et al. (2021) identified efficient nursing interventions that, when tailored to individual patient needs, effectively reduce PI occurrence among critical care populations.

Reflection on Practicum Experience, Including Accomplishments and Challenges

During my practicum, I successfully applied a PICOT-based PI prevention bundle aimed at minimizing PI incidence and related complications in elderly critical care patients. This included conducting patient education to promote self-management and increase awareness of PI prevention strategies. The intervention demonstrated improvements in patient outcomes, reflected in a lower PI incidence rate.

However, challenges arose related to resource limitations and coordination difficulties with multidisciplinary healthcare teams. Despite these obstacles, I remained committed to addressing the specific needs of PI management in the critical care environment. This experience underscored the importance of empowering both healthcare providers and patients through knowledge and practical tools, ultimately contributing to better health outcomes for this vulnerable population.

Completion of Practicum Hours

I completed 20 practicum hours implementing the PICOT-driven PI prevention bundle within a critical care setting. This hands-on experience deepened my understanding of PI care protocols and highlighted the essential role of self-care education in preventing complications. It also enhanced my awareness of how organizational resources impact the delivery and effectiveness of PI interventions.

Conclusion

My practicum reinforced the importance of evidence-based medical interventions in improving outcomes for patients at risk of pressure injuries. Peer-reviewed literature supports the use of PI prevention bundles and patient-centered self-care approaches as effective strategies to reduce PI risk and promote healing in elderly critical care patients.

References

Alshahrani, B., Sim, J., & Middleton, R. (2021). Nursing interventions for pressure injury prevention among critically ill patients: A systematic review. Journal of Clinical Nursing, 30(15-16), 2151-2168. https://doi.org/10.1111/jocn.15709