Chamberlain College of Nursing
NR451 RN Capstone Course
Term and Year
The introduction of technology in the health industry helps medics to run services and procedures faster and safer. The reliance of technology in such services has grown over the past few decades, with hospitals investing heavily in upcoming technologies to increase their efficiency. Its benefits continue to make the industry grow with new medicines, vaccines and surgery procedures. It plays a major part in health care especially towards the weak, old or those in critical care. The medics can monitor their patients from the comfort of their home and provide effective medication and solutions in real time. According to research, the use of pressure relieving devices, repositioning, and incontinent care aid on residents will help prevent and reduce acquired decubitus ulcers. The paper will look into these devices and their benefits towards the care of people living with acquired decubitus ulcers.
Almost everyone has pressure sores, though some have fewer than others. They develop when one stands in one position for a long period, exerting pressure on the sores. Common areas of development include back, elbows hips, ankles and heels. Skin and bone in these areas are close to each other, providing an opportunity for the sores to develop. The pressure sores are harmful to one’s health and body as they might render one bedridden or on a wheelchair. Some less severe symptoms are inability to change position when sleeping. Very few people notice these changes as most of them cite body changes as the cause for the pores. Most of them seek medical help after prolonged ailment and lack of proper medication or assessment of the disease.
Change Model Overview
The Nursing Evidence-Based Practice (EBP) model developed by John Hopkins comprises of three essential cornerstones: research, education, and practice. They help guide researchers and the nursing fraternity to undertake professional nursing. It starts off with problem identification, where one states the issue and reason as to why it needs immediate attention. The next step is providing in-depth evidence for the topic, with proper references and citation of resources. The last step is translation phase where the research undergoes an evaluation to determine whether it is a justifiable research or not as well as provide their opinion towards future developments.
The model employs 18 steps in the three phases, whereby the first phase has five steps. Moreover, the team selection and development of EBP question occur in the stage. The second phase consists of five more steps, where the team conducts their search and research to find suitable sources for the topic. The third face has eight steps, which begins with the collection of research material, grouping, evaluation, and final opinion. Hence, the model will be quite essential to the research topic and facilitate proper measures and suggestions towards it.
Practice Question
Step 1: Recruit Inter-professional Team
As the project manager and sole recruiter of the team, recruiting people to join in the project will require proper analysis and evaluation of preferred candidates. However, the project will incorporate other people with time since its timeline stretches to almost a year. The inter-professional team will have three stakeholders. The first one is clinical stakeholder for instance nurses, physicians and researchers and laboratory technicians. The second one is the local health officers and administration while the last one is patients, whereby select people will be part of the team. Other patients with the disease’s history will be part of the team but on a one on one basis.
Step 2: Develop and Refine the EBP Question
The EBP main objective is to determine whether pressure relieving devices, incontinent care aid, and repositioning will help prevent and reduce acquired decubitus ulcers. The condition is common with residents living in long-term skilled nursing facility. The staff does not use pressure relieving devices in their activities. Moreover, they do not reposition residents as per their schedule, toileting and attending to the incontinent patients. With the changes described in the paper, the number of cases will drop from 54 percent to 25 percent in the long run.
Step 3: Define the Scope of the EBP
In the nursing facilities stationed, there was an increasing rate of acquired decubitus ulcers on a weekly basis. The situation was out of hand, with little effort from the nurses and medics to help decrease the problem. None of them sought to determine the cause of the problem, and most of them cited external factors as the main cause. The quarterly wound report showed an increase of 20 percent of cases, setting off an alarm for immediate resolution towards the issue.
Steps 4 and 5: Determine Responsibility of Team Members
The members chosen for the project are essential to determining the problem, evaluating its causes and set guidelines to eradicate future issues. The clinical stakeholders will provide information for research, conduct their analysis and present the team with their findings. The local health officers and administrators will help collect data from other hospitals for comparison and evaluation. The patients are essential to the study as they act as test subjects though the team will seek their consent first before undertaking any tests on them.
Evidence
Steps 6 and 7: Conduct Internal/ External Search for Evidence and Appraisal of Evidence
Out of ten sources, the team narrowed down to four sources: one journal article and three peer-reviewed articles. The sources used are high evidence apart from one peer-reviewed article that composes of good evidence. They incorporate experimental, qualitative, quasi-experimental and descriptive study.
Steps 8 and 9: Summarize the Evidence
As stated in the PICO section, most of the patients suffering from acquired decubitus ulcers are bed ridden and have little to no help in changing their position or toileting (Barker et.al, 2013). Apparently, leaving urine and feces on the body for long will cause harm to the patient (Yap et.al, 2013). One of the causes is lack of proper nursing care especially scheduled visits by the nurses. The health workers play a major part in eradicating the problem according to a study done by Samuriwo (2012). It does not take extra knowledge or practice to provide patients with the proper care. The laziness exhibited in the various institutions will aid in the disease increase as time progresses. Proper interventions by the management will be essential in neutralizing the problem (Corcoran and Woodard, 2013).
Step 10: Develop Recommendations for Change Based on Evidence
One of the recommendations is conducting an assessment of the nurse’s schedule and activities undertaken. It will help management to determine the problem and provide appropriate measures. The management should schedule an immediate seminar or meeting to educate the nurses on effective measures and care when handling bed ridden patients. Lastly, the management should put in place strict rules for nurses, to govern their working schedules. Since they are at the center of the case, most of the recommendations will direct towards them.
The medics should look for definitive ways of combating the disease and prepare proper beddings and clothes to those affected. It is their mandate to contain the issue and provide adequate resources for prevention and care of patients. Moreover, the patients should help each other out by taking care of the ill patients or calling out the nurses. It is their right to ensure everyone receives adequate care in hospitals.
Translation
Steps 11, 12, and 13, 14: Action Plan
According to the EBP scope, the project will take a year to conduct the relevant study and evaluation fully. Study and observation will take up half the time since one cannot rush most of the procedures. The initial stage of selection will take a month, whereby the team will take another two months evaluating their options and conduct research. The second stage will take six months as it involves studying and assessing the patients. The last three months will include evaluation of the results to determine worthy reports.
Steps 16 and 16: Evaluating Outcomes and Reporting Outcomes
The report aims to evaluate the patient changes during the six months, where the team hopes to find a positive change in the cases and improve the health care industry.
Steps 17: Identify Next Steps
With the report at hand, the team will brief the local health board and seek their permission and approval to practice the findings in other institutions. The success of these institutions will open doors to other large scale areas, with various managements taking up the procedure and implementing in their institutions.
Step 18: Disseminate Findings
There will be quarterly reports on the findings and better methods of preventing and curing acquired decubitus ulcers. The team will use mailing services to inform the subscribed institutions and practitioners of new findings. Moreover, the team will set up a blog for the institutions and general public awareness.
Conclusion
The PICO question brings out a major problem exhibited in major health institutions across the globe: poor health care. Most of the illness and diseases occur in the hospital due to poor management and lack of concern by the medics. Nurses tend to be the main cause of such issues as they interact more with the patients. Hence, their treatment and care will affect their health. The health industry should take into consideration the services and care provided to patients through scheduled checkups and assessments.
References
Barker, A. L., Kamar, J., Tyndall, T.J., White, L., Hutchinson, A., Klopfer, N., & Weller, C. (2013). Implementation of pressure ulcer prevention best practice recommendations in acute care: an observational Wound Journal, 10(3), 313-320
Corcoran, E., & Woodard, S. (2013). Incontinence-associated dermatitis in the elderly: treatment options. British Journal Of Nursing, 22(8), 450-457.
Samuriwo, R. (2012). Pressure ulcer prevention: the role of the multidisciplinary team. British Journal Of Nursing, S4-S13
Yap, T. L., Kennerly, S. M., Simmons, M. R., Buncher, C. R., Miller, E., Kim, J., & Yap, W. Y. (2013). Multidimensional Team-Based Intervention Using Musical Cues to Reduce Odds of Facility-Acquired Pressure Ulcers in Long-Term Care: A Paired Randomized Intervention Study. Journal Of The American Geriatrics Society, 61(9), 1552-1559. doi:10.1111/jgs.12422
