In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each cont

Pressure Ulcer Prevention

Description of Pressure Ulcer Problem

The most recent reports from World Health Organization (W.H.O.) have indicated that pressure ulcers are becoming a deadly disease since it affects approximately 4 million adults. Pressure sores (commonly termed bedsores) are simply skin and underlying tissues injuries majorly caused by continued skin pressure. Reports indicate that the first diagnosed pressure ulcer was in 1993 after a 280000 hospital stays. In comparison to past reports, there has been about an 80% increase in bedsore patients. With this critical situation of Covid-19 (Yang, 2020), pressure ulcers have become more expensive since the average cost per hospital stay is $40000. With this increment rate, pressure ulcers disease is an upcoming pandemic among the elderly if the W.H.O. and N.G.O.s do not come up with safety goals to contain it. Just the way Covid-19 has increased hospitalizations, similar will happen to pressure ulcers patients among the elderlies (Tasdemir, 2021)

Pressure Ulcer Prevention Perspectives

During the nursing practice, it proved to me that it is a concern indeed. If the patient has bedsore, it is not necessarily the disease's fault but the nursing (Nightingale, 1859). Others view pressure ulcers as a result of a failure of the clinician associated with deteriorated nursing care. However, the clinicians blame the entire health care system for the development of any pressure ulcer. They argue that the healthcare team should incorporate nurses, physicians, physical therapists, and dietitians. It is correct that pressure ulcer is an interprofessional discipline that requires a diversified team that deals with its problem from its area of specialization. For this to be achieved, there must be effective communication, teamwork which is dictated by organizational culture. Therefore, significant change will be experienced when the system focuses on the anticipated change in the health care system (Ortelli, 2019).

Effects of Pressure Ulcer

After scrutinizing patients with pressure ulcers during the nursing practice, it was discovered that this disease only affects people due to inactivity. It majorly affected patients who had stayed in the hospital for a long time. The affected parts of the body lose sensation, fail to react to the hyperemia cycle of the pressure-prone area. The pressure ulcer's general effect is deteriorating someone's quality of life, morbidity, and mortality (Bonsall and Lynch, 2018).

Significance of Pressure Ulcer Prevention.

Prevention of pressure is crucial since it protects patients from harm and, most notably, reduces the costs of caring for them—increment of the elderly people population due to reduced deaths of the elderly.

Measures/ Solution for Pressure Ulcer Prevention

The best way to implement these practices for pressure ulcers is to help hospital staff carry out pressure ulcer prevention practices. These practices are enumerated in the implementation guide that the Agency of the healthcare team developed. The guidelines majorly incorporate the possible signs and symptoms of the pressure ulcers like inactivity, being overweight or underweight, inability to control your bowels, loss of sensation in the bedsore area. The prescribed measures to prevent pressure ulcers are, staying active always, treating your skin, self-care, taking sufficient water. The implementation measures indicated in the guidelines are risk assessment, skincare, mechanical loading, and staff education. After the continued application for the recommendations, the safety goals for patients will be easily be met (Mohammad, Nezafati and Eslaminejad, 2019)

References

Bonsall, L. M., Schnur, M. B., Fryling-Resare, K., & Lynch, L. (2018). 2018 Guide to Nursing Certification Boards. Dimensions of Critical Care Nursing, 37(6), 294-301.

Chlebowski, M. M., Baltagi, S., Carlson, M., Levy, J. H., & Spinella, P. C. (2020). Clinical controversies in anticoagulation monitoring and antithrombin supplementation for ECMO. Critical Care, 24(1), 1-12.

Gao, M., Yang, L., Chen, X., Deng, Y., Yang, S., Xu, H., ... & Gao, X. (2020). Covid 19 is not Contagious: New Government Study–NCBI. NLM. NIH. gov. Respir Med, 106026.

Ortelli, T. A. (2019). The National Library of Medicine. A.J.N. The American Journal of Nursing, 119(7), 53-54.

Sönmez, M., Taşdemir, N., & Ören, N. (2021). Pressure Injury Knowledge of Turkish Internship

Students. Journal of Tissue Viability.

Sousa, Á. F. L. D., Queiroz, A. A. F. L. N., Oliveira, L. B. D., Moura, M. E. B., Batista, O. M. A., & Andrade, D. D. (2016). Social representations of biosecurity in nursing: occupational health and preventive care. Revista brasileira de enfermagem, 69, 864-871.

Stoven, G., Lachal, J., Gokalsing, E., Baux, L., Jehel, L., & Spodenkiewicz, M. (2018). Acceptability of the systematic screening of suicidal adolescents in emergency departments. Coins. Psychiatrie, 39(316), 27-29.

Zaccagnini, M., & Pechacek, J. M. (2019). The doctor of nursing practice essentials: A new model for advanced practice nursing. Jones & Bartlett Learning.

Strategic Plan Summary

Summary Plan for Intervention for the Prevention of Pressure Ulcers

From the previous papers, my proposed primary method of preventing pressure ulcers among the hospitalized patients is turning the patients at least once per hour or using pressure distribution mattresses or devices, Gefen et al. (2020). However, based on the Pennsylvania healthcare facility’s culture assessment, I noted potential challenges that may make my proposed nursing interventions unsuccessful. Firstly, is that the organization faced a challenge for not providing adequate education to patients and their caregivers. From my research about facility and interview, most patients never knew about potential causes of pressure ulcers and how they could be prevented by either turning themselves or calling nurses to assist them at least once per hour.

This problem will be solved by making organizational culture changes where patients are given first priority through education regarding avoiding remaining in the same position for a long time and asking the nurse’s help. Secondly, the nurses will be educated on reducing pressure ulcers among the patients since it’s a common condition, especially during the current pandemic where patients receive ventilator or respirators care. This can include ensuring that the correct mask is worn, ensuring the clean surface, and adjusting it often. Finally, the Pennsylvania healthcare facility should acquire pressure distribution mattresses which will be a better option for the patients in the ICU. This will reduce pressure on some parts of the body, which will prevent the development of sores. Despite many authors arguing that pressure mattresses are ineffective, they are an excellent option for preventing ulcers. Jaul et al. (2018).

References

Gefen, A., Alves, P., Ciprandi, G., Coyer, F., Milne, C. T., Ousey, K., ... & Worsley, P. (2020). Device-related pressure ulcers: SECURE prevention. Journal of wound care, 29(Sup2a), S1-S52. https://www.magonlinelibrary.com/doi/abs/10.12968/jowc.2020.29.Sup2a.S1

Jaul, E., Barron, J., Rosenzweig, J. P., & Menczel, J. (2018). An overview of co-morbidities and the development of pressure ulcers among older adults. BMC geriatrics, 18(1), 1-11. https://link.springer.com/article/10.1186/s12877-018-0997-7

Capstone Topic Summary

After collaboration with my preceptor, I identified the evidence base topic, “Pressure ulcer prevention.” The prevention of pressure ulcers is a quality-of-care indicator. Pressure ulcers are a major nurse-sensitive outcome. As a result, nursing care has a significant impact on the development and prevention of pressure ulcers. According to my research, not all pressure ulcers can be prevented, but the majority of pressure ulcers can be prevented by using complete pressure ulcer programs. My anticipation entails providing health-care providers with training on how to prevent a pressure ulcer, including: who is most likely to develop them; how to spot pressure damage; what steps to take to prevent new or further pressure damage; and who to contact for more information and action. How to do a risk and skin evaluation; how to reposition; information on pressure redistributing devices; discussion of prevention with patients and their caregivers; and details of sources of help and support are all covered in the training. My research also implies that randomized controlled trials are needed to determine the best management techniques based on the stage of the ulcers, as well as the comorbidities and severity of the illness. The anticipation of presenting this topic included research on educating the adherence for not only to the patients or the community but also the medical staff at my capstone project organization. The patients involved are with the ailments of cardiac health issues, incontinent, stroke patients and patients with diabetic. My topic would support both the community and the leadership category.

References:

Lyder CH, Ayello EA. Pressure Ulcers: A Patient Safety Issue. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 12 Available from: https://www.ncbi.nlm.nih.gov/books/NBK2650/

Parnham, A., Pankhurst, S., & Dabell, W. (2015). Reducing avoidable pressure ulcers in the community. Nursing standard (Royal College of Nursing (Great Britain), 1987),29(26), 62–70. https://doi.org/10.7748/ns.29.26.62.e9656