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Implementation of an Evidence-Based Practice to Prevent Pressure Ulcers

Projektarbeit 2014 9 Seiten

Pflegewissenschaft, Ernährung, Sport, Gesundheit - Pflegewissenschaft - Sonstiges

Leseprobe

Table of Contents

Introduction

PICOT Question

Infrastructure to Support Change

Summary of Synthesized Literature Review of Current Recommended Practice
Literature Search
Synthesis

Proposed Practice Change

Change Strategy
Promoting Engagement
The Model for Evidence-Based Practice Change

Roll Out Plan

Project Evaluation

Dissemination of EBP

References

Introduction

Pressure ulcers, caused by prolonged immobility, are increasing among hospital patients. They can cause patient discomfort and infection, may increase treatment time, length of hospital admission, medical bills, and can potentially cause death (AHRQ, 2009). Current guidelines recommended by the AHRQ aid nursing staff in pressure ulcer prevention; however, the combination of specialty skin products, silicone dressings, and a 4-hour turning schedule may prevent pressure ulcers entirely.

PICOT Question

To identify a need for change, and to develop a change in practice project, the following PICOT question was developed. In the adult cardiac patient population, how does the preventative use of natural cleansers and nutrient emollients, the application of foam dressings, and a 4-hour turning schedule in comparison to the use of aloe vesta soap and lotion alone, no dressings, and a 2- or 3-hour turning schedule affect the rate of pressure ulcer development within three months?

Infrastructure to Support Change

Sarasota Memorial Healthcare System, a magnet recognized not-for-profit organization, is committed to delivering safe, high-quality care that results in desired outcomes and is consistent with current professional knowledge (Mission Statement/Vision, para. 4). The organizational culture is reflected in the mission statement as well as the organization’s participation with several agencies including The Joint Commission, the Agency for Healthcare Research and Quality Patient Safety Indicators, the American Nurses Credentialing Center Magnet Program (Sarasota Memorial Quality Report, para.4), and many other health care accrediting agencies. Interdisciplinary collaboration is encouraged as evidenced by interdiscipli-nary meetings that focus on identifying the need for change and implementing evidence-based practice (EBP). Change that results in improved patient outcomes is encouraged by the executive team, risk management, nurse educators, several practice councils, and unit managers. Initiation of and participation in change is recognized by “nurse of clinical excellence” awards. At SMH, proposed changes are commonly presented to unit practice councils (UPC) throughout the organization. Council members vote on the proposed change, and if the majority of the UPC members and council chair agree upon the proposal, the specified change in practice is implemented systematically.

Summary of Synthesized Literature Review of Current Recommended Practice

Literature Search

PubMed, NCBI, and CINHAL were used to find research containing relevant information and clinical guidelines regarding pressure ulcer prevention. The key terms used in this search were pressure ulcer, prevention, border foam dressing, and critical patient.

Three peer-reviewed articles and one clinical guideline were selected for evaluation and synthesis.

Synthesis

Examination of the literature discussing pressure ulcer prevention has demonstrated that rates of pressure ulcer development can be reduced. Bergstrom et al. (2013) found that a 4-hour turning schedule is sufficient in pressure ulcer prevention. Santamaria et al. (2013) found that the application of soft silicone multi-layered foam dressings led to a 10% reduction rate of pressure ulcer development. Shannon et al. (2012) found that the use of a Pressure Ulcer Prevention Program (PUPP) led to a 67% incidence reduction as it pertains to pressure ulcer development in nursing homes.

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Details

Seiten
9
Jahr
2014
ISBN (eBook)
9783668024182
ISBN (Buch)
9783668024199
Dateigröße
386 KB
Sprache
Englisch
Katalognummer
v303837
Institution / Hochschule
University of South Florida
Note
98%
Schlagworte
implementation evidence-based practice prevent pressure ulcers

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Titel: Implementation of an Evidence-Based Practice to Prevent Pressure Ulcers