An ongoing quality improvement initiative in my clinical setting is aimed at minimizing the number of pressure wounds in patients in the nursing home or long-term care. The management of the healthcare organization started the quality improvement initiative last year.
Summary of the initiative
It has been shown that pressure wounds are common in old people and the sick who have limited levels of movement. Such patients spend most of their time sleeping. Thus, some portions of their skins are in continuous exposure to the body weight. Pressure wounds develop when a part of the skin is subjected to some forces (pressure) that interfere with the structure of the skin. This process results in lesions on the skin, which culminate in open wounds. The quality improvement initiative was started at the facility to reduce the harm that pressure wounds cause to patients. Previously, pressure wounds contributed to lower quality care within the healthcare organization. To assess the outcomes of the initiative, the management collects data on a routine basis. The data are gathered from patients residing in the wards. Once they are collected, they are entered into the computer and analyzed to obtain important findings of the success or failure of the program. If the management finds that the number of patients suffering from pressure wounds is not decreasing, then other measures would be adopted.
How the initiative will affect care practice
If it succeeds, then the program will positively affect healthcare practice within the facility. Patients will have shorter recovery periods because they will not be affected by the pressure wounds when in the hospital beds. This would result in better workflows because healthcare providers would be motivated to work within the facility. A motivated workforce will result in improved patient outcomes about other diseases and/or health conditions. Also, healthcare providers would be more experienced in the prevention of pressure wounds. In addition, this program will impact healthcare practice by equipping staff with excellent data collection and analysis experiences (American Psychological Association, 2010; Bush & Hauschildt, 2006).
A summary on Lyder, C. H. (2003). Pressure ulcer prevention and management. Jama, 289(2), 223-226.
The study author designed a study to determine the various approaches to preventing pressure ulcers or wounds. The number of patients who develop pressure wounds in clinical settings varies from one facility to another. The study reviewed published articles to assess the methods used to prevent pressure wounds in patients. The article established that surgery was a viable option that was adopted by many physicians to prevent pressure wounds. However, the rate of recurrence was relatively high. Electrical stimulation is the other approach that is used to manage pressure wounds. This method was found to increase the number of neutrophils, collagen materials, and receptors for growth factors. The study author contends that prevention initiatives aim to reduce incidence rates. Thus, healthcare providers should adopt cost-effective approaches. Further research was recommended in the future to determine the most effective method of preventing pressure wounds (Lyder, 2003).
A summary on Reddy, M., Gill, S. S., & Rochon, P. A. (2006). Preventing pressure ulcers: a systematic review. Jama, 296(8), 974-984.
The study aimed to review the literature on evidence-based interventions aimed at preventing pressure wounds. Specifically, findings from randomized controlled trials were reviewed. The study authors worked with a sample size of 59 randomized controlled trial articles. All the articles selected were published in peer-reviewed international journals. Specific search items were used to identify the articles of interest. It was established that most studies used support surfaces, and specialized sheepskin overlays to address altered mobility. The authors assert that there is limited evidence to suggest that particular turning regimens could benefit a patient characterized by limited mobility. The study found that dietary supplements could help prevent pressure wounds in patients with nutrient deficiencies. However, the benefit of topical agents in preventing pressure wounds was unclear. The authors recommend comprehensive studies in the future to assess the benefits of different measures that could be used to prevent pressure wounds in patients (Reddy, Gill & Rochon, 2006).
Evidence-based practice and research findings
The initiative in the healthcare facility relies on the application of evidence-based practice and research findings. Findings from previous studies are used to form the basis of offering prevention regimens. The selected regimens should have demonstrated high levels of efficacy and patient safety. High levels of efficacy imply that a regimen produces significant biological changes while patient safety refers to a small number of adverse side effects. Thus, they are expected to result in more benefits than adverse side effects. Evidence-based practice is supported by evidence-based research findings (Sullivan & Decker, 2013). Therefore, the initiative uses an evidence-based practice that has been reported in previous studies. The benefit of using evidence-based healthcare practices and research findings is that they result in lower costs and better patient outcomes. In summary, the quality improvement program will result in enhanced healthcare outcomes and cost savings.
References
American Psychological Association. (2010). Publication manual of the American Psychological Association (6th ed.). Washington, DC: American Psychological Association.
Bush, J., & Hauscildt, J. (2006). Nursing leadership and management review module edition 4.1 (8th ed.). Overlook Park, Kansas: Technologies Institute, LLC.
Lyder, C. H. (2003). Pressure ulcer prevention and management. Jama, 289(2), 223-226.
Reddy, M., Gill, S. S., & Rochon, P. A. (2006). Preventing pressure ulcers: a systematic review. Jama, 296(8), 974-984.
Sullivan, E. J. & Decker, P.J. (2013). Effective leadership and management in nursing. (8th ed.). Upper Saddle River, NJ: Pearson Educational, Inc.