[Audio] Pressure ulcers and injuries are common occurrences that are generally avoidable in an inpatient setting. Medical patients with older age groups, incapacity to move independently, method of arrival, and no skin examination or pressure injury risk assessment at admission had a higher risk of hospital-acquired pressure injuries (Tervo-Heikkinen, 2022). Hospital-acquired pressure injuries (HAPIs) on two medical-surgical units were identified as financial and patient outcome concerns (Black, 2019). There is currently a process in place for repositioning the patient every two hours, but it is not always performed.
PICOT questions are the following; In adult inpatients (P), does the implementation of a comprehensive pressure injury prevention program by nurses (I), compared to standard pressure injury prevention practices (C), result in a reduction in the occurrence of pressure injuries (O) during the hospital stay (T)? Stakeholders include inpatient Nurse, patient care tech, physicians, wound care nurse, charge nurse/ floor managers. Nurses play a major role in HAPI prevention as an indicator for quality nursing care. Action plans would include skin inspection within 8 hours upon admission, every time there is a change in condition, and prior to discharge from the hospital, the Braden risk scoring tool would be utilized for every shift change, daily auditing documentation of patient repositioning, yearly HAPI education for nurses and CNAs, assessing malnutrition within a week of admission. The suggested action plans are logical and achievable because they are consistent with recognized best practices for enhancing patient safety, reducing problems, and delivering adequate treatment. They promote early detection, prompt action, education, and preventative measures to enhance patient outcomes and treatment quality. Potential Barriers and how to mitigate them include resistance to change. To mitigate this, engage stakeholders early in the process and address concerns. The second is a lack of clear expectations. To mitigate this, the administration should set clear goals and objectives. The third is a lack of resources. To mitigate this, assess resources and identify any gaps and limitations. The fourth is a lack of communication. To solve this, provide regular updates. Lastly, is the misunderstanding of the evidence related to PI. The organization can provide continuing education and training. Outcome Measures: Current pressure injury data is 5 HAPI cases per 1,000 patient days. HAPI cases down to three in one month. HAPI cases are down to 2 in 3 months. HAPI case down to 1 case at 6 months. The outcome measurements motivate team members to offer high-quality treatment and a great patient experience. While a productivity emphasis needs outputs and puts pressure on stakeholders to produce results, an efficiency focus deals with modification of processes and necessitates organizational transformation. Thus, ideally, a focus on efficiency should enable staff to accomplish performance metrics while boosting workplace well-being since resources and procedures are more efficient, and team members are working at the top of their abilities. For the Quadruple Aim, patient experience improved, population health improved, healthcare costs were reduced, and health care provider work lives were evaluated and improved. Hospital-acquired pressure injuries (HAPIs) affect 1 in 30 patients and cause 60,000 fatalities annually (Englebright et al., 2018). In conclusion, pressure redistribution, team collaboration, and improved education should be routinely used to control HAPI risk in acute hospitals. Implementing evidence-based practices and involving stakeholders promotes teamwork and communication. One way to. 

Scene 1

Quality Improvement Presentation Poster Barbara Polo Capella University Evidence-Based Practice for Patient-Centered Care and Population Health Evidence-Based Practice Implementation Plan June 26, 2023

Hospital-acquired pressure injuries (HAPIs) on two medical-surgical units were identified as financial and patient outcome concerns (Black, 2019). There is currently a process in place for repositioning the patient every two hours, but it is not always performed.

Inpatient Nurse Patient care tech Physicians Wound Care Nurse Charge Nurse/ Nurse Manager

Arnetz , B. B., Goetz, C. M.,  Arnetz , J. E., Sudan, S.,  vanSchagen , J.,  Piersma , K., &  Reyelts , F. (2020). Enhancing healthcare efficiency to achieve the Quadruple Aim: an exploratory study.  BMC research notes ,  13 (1), 362.  https://doi.org/10.1186/s13104-020-05199-8 Black, J., &  Maegley , J. (2019). Help-U to Prevent HAPI: A Change Project to Attain Zero HAPIs.   Medsurg  Nursing, 28 (1), 31-34,47.  http://library.capella.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Fhelp-u-prevent-hapi-change-project-attain-zero%2Fdocview%2F2184399020%2Fse-2%3Faccountid%3D27965 Cyriacks , B., & Spencer, C. (2019). Reducing HAPI by cultivating team ownership of prevention with budget-neutral turn teams.   Medsurg  Nursing, 28 (1), 48-52. http://library.capella.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Freducing-hapi-cultivating-team-ownership%2Fdocview%2F2184399501%2Fse-2%3Faccountid%3D27965 Englebright, J., Westcott, R., McManus, K.,  Kleja , K., Helm, C.,  Korwek , K.M., & Perlin, J.B. (2018). A comprehensive program to reduce rates of  hospitalacquired  pressure ulcers in a system of community hospitals. Journal of Patient Safety, 14(1), 54-59. Tervo -Heikkinen, T. A.,  Heikkilä , A.,  Koivunen , M.,  Kortteisto , T. R.,  Peltokoski , J.,  Salmela , S.,  Sankelo , M.,  Ylitörmänen , T. S., & Junttila, K. (2022). Pressure injury prevalence and incidence in acute inpatient care and related risk factors: A cross-sectional national study.  International wound journal ,  19 (4), 919–93  Tervo -Heikkinen, T.,  Heikkilä , A.,  Koivunen , M.,  Kortteisto , T.,  Peltokoski , J.,  Salmela , S.,  Sankelo , M.,  Ylitörmänen , T., & Junttila, K. (2023). Nursing interventions in preventing pressure injuries in acute inpatient care: a cross-sectional national study.  BMC nursing ,  22 (1), 198. https://doi.org/10.1186/s12912-023-01369-8 1.  https://doi.org/10.1111/iwj.13692

Resistance to change-Engage stakeholder early in the process and address concerns Lack of  clear expectations of task-Set clear goals and objectives Lack of resources-Assess resources and identify any gaps and limitations Lack of communication—Provide regular updates M isunderstanding of the evidence related to PI-Provide education and training

Current pressure injury data is 5 HAPI cases/1,000 patient days. HAPI cases down to 3 cases  in 1 month HAPI cases down to 2 cases  in 3 months HAPI case down to 1 case at 6 months

Skin inspection within 8 hours upon admission, every time there is a change in condition and prior to discharge  Braden risk scoring every shift change Daily a uditing documentation of patient repositioning Yearly HAPI education for nurses and CNA Assessing malnutrition within a week of admission

Patient experience improved Population health improved Healthcare costs reduced Health care provider work life- evaluated and improved

A picture containing drawing, cartoon, illustration

Description automatically generated

This Photo  by Unknown Author is licensed under  CC BY

In adult inpatients (P), does the implementation of a comprehensive pressure injury prevention program by nurses (I), compared to standard pressure injury prevention practices (C), result in a reduction in the occurrence of pressure injuries (O) during the hospital stay (T)?

Quality Improvement Presentation Poster
Barbara Polo
Capella University
Evidence-Based Practice for Patient-Centered Care and Population Health
Evidence-Based Practice Implementation Plan
June 26, 2023

Pressure ulcers and injuries are common occurrences that are generally avoidable in an inpatient setting

Medical patients with older age groups, incapacity to move independently, method of arrival, and no skin examination or pressure injury risk assessment at admission had a higher risk of hospital-acquired pressure injuries (Tervo-Heikkinen, 2022)

Hospital-acquired pressure injuries (HAPIs) on two medical-surgical units were identified as financial and patient outcome concerns (Black, 2019)

There is currently a process in place for repositioning the patient every two hours, but it is not always performed.

Stakeholders include inpatient Nurse, patient care tech, physicians, wound care nurse, charge nurse/ floor managers.

Nurses play a major role in HAPI prevention as an indicator for quality nursing care

Action plans would include skin inspection within 8 hours upon admission, every time there is a change in condition, and prior to discharge from the hospital, the Braden risk scoring tool would be utilized for every shift change, daily auditing documentation of patient repositioning, yearly HAPI education for nurses and CNAs, assessing malnutrition within a week of admission

The suggested action plans are logical and achievable because they are consistent with recognized best practices for enhancing patient safety, reducing problems, and delivering adequate treatment

They promote early detection, prompt action, education, and preventative measures to enhance patient outcomes and treatment quality

Potential Barriers and how to mitigate them include resistance to change

To mitigate this, engage stakeholders early in the process and address concerns

The second is a lack of clear expectations

To mitigate this, the administration should set clear goals and objectives

To mitigate this, assess resources and identify any gaps and limitations

Lastly, is the misunderstanding of the evidence related to PI

The organization can provide continuing education and training.

Current pressure injury data is 5 HAPI cases per 1,000 patient days

The outcome measurements motivate team members to offer high-quality treatment and a great patient experience

While a productivity emphasis needs outputs and puts pressure on stakeholders to produce results, an efficiency focus deals with modification of processes and necessitates organizational transformation

Thus, ideally, a focus on efficiency should enable staff to accomplish performance metrics while boosting workplace well-being since resources and procedures are more efficient, and team members are working at the top of their abilities.

For the Quadruple Aim, patient experience improved, population health improved, healthcare costs were reduced, and health care provider work lives were evaluated and improved

Hospital-acquired pressure injuries (HAPIs) affect 1 in 30 patients and cause 60,000 fatalities annually (Englebright and others, 2018)

In conclusion, pressure redistribution, team collaboration, and improved education should be routinely used to control HAPI risk in acute hospitals

Implementing evidence-based practices and involving stakeholders promotes teamwork and communication

avatar

 Arnetz , B. B., Goetz, C. M.,  Arnetz , J. E., Sudan, S.,  vanSchagen , J.,  Piersma , K., &  Reyelts , F. (2020). Enhancing healthcare efficiency to achieve the Quadruple Aim: an exploratory study.  BMC research notes ,  13 (1), 362.  https://doi.org/10.1186/s13104-020-05199-8 Black, J., &  Maegley , J. (2019). Help-U to Prevent HAPI: A Change Project to Attain Zero HAPIs.   Medsurg  Nursing, 28 (1), 31-34,47.  http://library.capella.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Fhelp-u-prevent-hapi-change-project-attain-zero%2Fdocview%2F2184399020%2Fse-2%3Faccountid%3D27965 Cyriacks , B., & Spencer, C. (2019). Reducing HAPI by cultivating team ownership of prevention with budget-neutral turn teams.   Medsurg  Nursing, 28 (1), 48-52. http://library.capella.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Freducing-hapi-cultivating-team-ownership%2Fdocview%2F2184399501%2Fse-2%3Faccountid%3D27965 Englebright, J., Westcott, R., McManus, K.,  Kleja , K., Helm, C.,  Korwek , K.M., & Perlin, J.B. (2018). A comprehensive program to reduce rates of  hospitalacquired  pressure ulcers in a system of community hospitals. Journal of Patient Safety, 14(1), 54-59. Tervo -Heikkinen, T. A.,  Heikkilä , A.,  Koivunen , M.,  Kortteisto , T. R.,  Peltokoski , J.,  Salmela , S.,  Sankelo , M.,  Ylitörmänen , T. S., & Junttila, K. (2022). Pressure injury prevalence and incidence in acute inpatient care and related risk factors: A cross-sectional national study.  International wound journal ,  19 (4), 919–93  Tervo -Heikkinen, T.,  Heikkilä , A.,  Koivunen , M.,  Kortteisto , T.,  Peltokoski , J.,  Salmela , S.,  Sankelo , M.,  Ylitörmänen , T., & Junttila, K. (2023). Nursing interventions in preventing pressure injuries in acute inpatient care: a cross-sectional national study.  BMC nursing ,  22 (1), 198. https://doi.org/10.1186/s12912-023-01369-8 1.  https://doi.org/10.1111/iwj.13692

slide1-hotlink27

 This Photo  by Unknown Author is licensed under  CC BY