FPX206011

Evidence-Based Practice Implementation Plan for Pressure Ulcers

Pressure ulcers, also known as bed sores, pose a challenge for all immobile patients or those subjected to prolonged bed rest. Rational management and preventive measures enhance the patient's comfort and reduce complications (Zaidi & Sharma, 2024). This assessment concerns evidence-based practice regarding the prevention and treatment of pressure ulcers. It is intended to ensure that the care provided is of high quality and that pressure ulcers do not develop in vulnerable people by basing practice on current literature and clinical guidelines.

Background

Pressure ulcers, also known as bedsores or decubitus ulcers, are localized tissue injuries to the skin caused by prolonged pressure, friction, or shear. These ulcers are a common complication of hospitalized patients with difficulty moving, decreased sensations, malnutrition, and other underlying health conditions. The severity of these ulcers can range from mild redness of the skin to deep full-thickness wounds with exposure of muscle, tendon, or bone. Pressure ulcers have great economic implications for health systems as they will increase the treatment cost (Zaidi & Sharma, 2024). Affected people also suffer from a reduction in quality of life due to pressure ulcers. Assessing risk factors, preventive practices, and timely intervention therefore are indispensable measures taken to limit their occurrence and effects.

PICOT Question

In patients at high risk of developing pressure ulcers (P), does implementing a structured pressure ulcer prevention protocol (I), as compared to standard care (C), lead to a decrease in the incidence of hospital-acquired pressure ulcers (O) within the first 3 days of hospitalization (T)?

● Population: Patients with limited mobility or on prolonged bed rest

● Intervention: Introduction of a structured pressure ulcer prevention protocol

● Comparison: Standard care typically provided in hospital settings

● Outcome: Decrease in hospital-acquired pressure ulcers

● Timeframe: First 3 days of hospitalization

Action Plan

There is a need to implement a structured action plan for the prevention of pressure ulcers. This plan should be based on evidence-based recommendations, a timeline, and resources and tools required to implement the action plan.

Recommendations

The prevention of pressure ulcers must comprise evidence-based strategies in its comprehensive plan. The first step will be regular skin assessment using a validated tool, such as the Braden Scale, to identify patients at risk for developing pressure ulcers (Jansen et al., 2020). There is also a standardized requirement for patients at risk for pressure ulcers to be turned every two hours to ensure proper body positioning without exertion on bony prominences. Moreover, pressure-relieving devices, such as special mattresses, cushions, and heel protectors, will be available for high-risk patients. Nutritional support is also quite crucial; proper nourishment for the patient can advance skin integrity and aid in healing at the site of the wound (Langer et al., 2024). Last but not least, educating and training staff is integral to managing such patients. Regular training sessions will be conducted to educate the healthcare staff on the importance of preventing pressure ulcers, early detection, and appropriate treatments.

Timeframe

The implementation timeline of the protocol for pressure ulcer prevention will span over ten weeks. Training on the new protocol and employing the assessment tools will be done in Weeks 1-2, and in Weeks 3-4, the practical applications of a repositioning schedule, risk assessment, and nutritional support for patients at risk will be undertaken. High-risk patients 3 would be offered pressure-relieving devices by Weeks 5 and 6, and the protocol would be integrated into daily nursing activities. Outcomes of patients would be monitored, compliance checked, and adjustments in the protocol would be made as necessary from the feedback received during Weeks 7 and 8. The incidence rates of pressure ulcers would be measured in assessing the effectiveness of the action plan during Weeks 9-10 (Akello et al., 2020). The action plan is directly focused to prevent pressure ulcers and enhance the quality of care.

Tools and Resources

The tools and resources needed to employ the protocol of pressure ulcer prevention include the following key components. It would be employing the Braden Scale for effective and consistent risk assessment and identification of patients at risk for pressure ulcers. Pressure-relieving equipment, such as special mattresses, cushions, and heel protectors, would be used to avoid pressure on sensitive areas (Nixon et al., 2019). For patients who require a supplement to improve nutrition for enhanced skin integrity and healing, nutritional supplements will be utilized. For the preparation of staff in terms of prevention and treatment interventions, information-based preparation tools, and online media will be implemented. Data collection software will further be used to track the patients' outcomes and to monitor the pressure ulcer incidence rate to measure the effectiveness of the protocol.

Stakeholders and Potential Barriers

The key stakeholders for the pressure ulcer prevention project would include healthcare staff such as nurses, physicians, dietitians, and wound care specialists, followed by hospital administrators and, more importantly, the patients themselves. Nurses would very much be involved in the daily implementation of this plan, while physicians and dietitians would be contributing to patient care and nutrition planning, respectively. Hospital administrators would 4 be accountable for resource allocation and follow-through within implemented protocols (Laurisz et al., 2023). Pressure ulcers lead to increased costs and prolonged hospital stays. This can increase the workload of healthcare staff, including nurses and physicians. Increased workload will lead to staff burnout and declined quality of care. Moreover, the hospital administration will have to bear an additional financial burden owing to the increased demand for resources. Change resistance by staff, limited resources such as pressure-reducing equipment, and time limits for the staff to execute scheduled reviews and turns are all potential barriers to introducing the project. Poor training or empowerment of healthcare staff, or inconsistent adherence to newly agreed protocols, can also act as a barrier to its effective implementation (Tomas & Mandume, 2024). These can only be overcome with organizational teamwork, training, and administrative support.

Actions to Overcome Barriers

Specific actions could be taken to overcome barriers in implementing the pressure ulcer prevention project. Getting the staff engaged through regular meetings and feedback sessions would foster a culture of collaboration, openness to change, and general support among all members of the team with adequate training and continued support. The whole process starts with the establishment of a budget and then advocating for the necessary funding to ensure that ample resources, such as pressure-relieving devices and nutritional supplements, are secured (Morena et al., 2022). Clear communication outlining the benefits of the protocol and emphasizing why compliance is crucial can help motivate them toward the new practices. Lastly, having a champion or lead nurse for the project will bring monitoring and accountability within 5 the team.

Outcome Criteria

Some outcome criteria should be proposed to assess the effectiveness of the evidence-based practice project on the prevention of pressure ulcers. For example, a decrease in the rate of hospital-acquired pressure ulcers will constitute a primary outcome measure with specific targets set for improvement within the time frame of the project. Patient satisfaction surveys can also be conducted to measure perceived comfort and quality of care about pressure ulcer prevention strategies (Gaspar et al., 2019). Conformity rates on the repositioning protocol and the risk assessment procedures would also depict the adherence level of staff to new practices. Furthermore, the nutrition status of the patient would be monitored by conducting regular assessments on dietary intake and weight changes. In conclusion, feedback from the staff members regarding the training and implementation process can give an overview of whether the whole project process is effective or not and what improvement needs to be made.

Alignment with Quadruple Aim

The proposed outcome measurements for the pressure ulcer prevention project are compatible with the Quadruple Aim, where improvements in patients' experience are emphasized along with population health, reduction of costs, and support for healthcare providers. Reducing the incidence of hospital-acquired pressure ulcers enhances patient experience and comfort, thus enabling overall satisfaction with care. Better nutritional status and adherence to the repositioning protocols can, therefore, be associated with improved health of the at-risk population, which is in keeping with improved population health. Prevention of pressure ulcers can also significantly reduce costs linked with complications and prolonged hospital stays, thus reducing general healthcare costs (Arnetz et al., 2020). Finally, by ensuring proper staff training 6 and resources, the project serves to assist healthcare providers in fostering an engaged and knowledgeable workforce that is integral to patient care.

Evaluation of the Evidence

The rationale for the needed practice change to prevent pressure ulcers was gathered through a literature search conducted in the databases of PubMed, CINAHL, and Cochrane Library using the search terms "pressure ulcer prevention," "evidence-based practice," "risk assessment," and "pressure-relieving devices." Several studies and systematic reviews focused on pressure ulcers, which became a significant burden on healthcare systems mainly through prolonged stays in hospitals and high treatment costs. The gathered literature was highly credible as it was retrieved from authentic sources and databases. Moreover, these studies are recent and are relevant to the topic of this assessment. Recent literature serves as the most credible source of information and provides the best evidence to be implemented in practice. The included studies are also relevant and provide evidence-based strategies to prevent pressure ulcers.

Summary of Findings

Pressure ulcers are a high cost to healthcare resources because of the costs of their associated treatments, extended stays within hospitals, and decreased quality of life for patients diagnosed with pressure ulcers. Quality, evidence-based studies clearly show the impact that preventing pressure ulcers with effective strategies has on reducing the incidence of pressure ulcers. The key interventions are changing the alternating foam mattresses, adhering to international guidelines on turning frequency and skin checks, and ensuring the right nutritional supplementation (Nixon et al., 2019). For instance, an aggressive prevention protocol implemented in a long-term care facility reduced pressure ulcers from 23% to as few as 5% within six months (Lyder & Ayello, 2019). Therefore, such evidence makes the need to 7 implement evidence-based practices more vital because it will allow for substantial improvement in patient outcomes and overall improvements in quality care in a clinical setting.

Conclusion

In a nutshell, implementing evidence-based practices for pressure ulcer prevention can determine the quality of patient care and optimization of healthcare resources. Given the unrelenting occurrence of pressure ulcers that significantly influence cost, hospital stay, and patient quality of life, it is essential that such strategies as validated assessments, repositioning protocols, pressure-relieving devices, and proper nutritional support be given much importance. Convincing evidence in favor of these practices demonstrates just how effective they can be; further, to ensure a culture of prevention, there is a continued need for the education of staff. Finally, putting priority on pressure ulcer prevention will further strengthen patient outcomes, increase satisfaction levels, and ultimately help to build a more efficient health care service.