Recommending an Evidence Based Practice Change to Reduce

Recommending an Evidence -Based Practice Change to Reduce Pressure Ulcers [NAME] [INSTITUTION] [DATE]

Introduction • Best practice vs common practice • Clinical inquiry (Melnyk & Fineout-Overholt, 2019) • Dissemination and adoption (Brownson et al. , 2018) • Pressure ulcers as a QI issue

The Healthcare Organization • Tertiary care institution • Continuous QI culture • Resistance to change challenge • Transformational leadership

Current Problem & Opportunity for Change • Pressure ulcers as a QI concern • Rising rates of PU as per Braden Scale (Ayello, n. d. ) • Scope & stakeholders • Risks

The Evidence-Based Idea for Change • Knowledge about risk factors (Ahtiala et al. , 2018; Tayyib & Coyer, 2016) • Staff training • Comprehensive approach • HALT (Ayello, n. d. ).

The Plan for Knowledge Transfer • PICOT (Melnyk & Fineout-Overholt, 2019). • Dissemination of findings (Brownson et al. , 2018) • Adoption & implementation • Evaluation

The Measurable Outcomes • A drop in incidence by half in 30 days • Shorter hospital stays • Less expenditure on healthcare • Higher patient satisfaction rating

Lessons Learnt & Critical Appraisal • High PU risk in non-ambulatory critical care patients (Ahtiala et al. , 2018) • Positive correlation with obesity & malnutrition (Ness et al. , 2018) • PUs & increased hospitalization costs (Demarré et al. , 2015) • Timely comprehensive risk assessment as evidence-based prevention (Tayyib & Coyer, 2016) • Lesson: Systematic reviews have highest evidence • Lesson: Bundled approach more preferable

Conclusion • Importance of EBP • Role of clinical inquiry • Quality improvement • PUs as a QI issue

References • Ahtiala, M. , Soppi, E. , & Tallgren, M. (2018). Specific risk factors for pressure ulcer development in adult critical care patients: A retrospective cohort study. EWMA Journal, 19(1), 35– 42 • Ayello, E. A. (n. d. ). Using pressure ulcer risk assessment tools in care planning. Agency for Healthcare Research and Quality (AHRQ). https: //www. ahrq. gov/sites/default/files/wysiwyg/professionals/systems/hospital/pressure_ulcer_prevention/ webinars/webinar 5_pu_riskassesst-tools. pdf • Brownson, R. C. , Eyler, A. A. , Harris, J. K. , Moore, J. B. , & Tabak, R. G. (2018). Getting the word out: New approaches for disseminating public health science. Journal of Public Health Management and Practice, 24(2), 102– 111. https: //doi. org/10. 1097/PHH. 0000000673 • Demarré, L. , Van Lancker, A. , Van Hecke, A. , Verhaeghe, S. , Grypdonck, M. , Lemey, J. , Annemans, L. , & Beeckman, D. (2015). The cost of prevention and treatment of pressure ulcers: A systematic review. International Journal of Nursing Studies, 52(11), 1754– 1774. https: //doiorg. ezp. waldenulibrary. org/10. 1016/j. ijnurstu. 2015. 06. 006

References (cont’) • Melnyk, B. M. , & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4 th ed. Wolters Kluwer. • Ness, S. J. , Hickling, D. F. , Bell, J. J. , & Collins, P. F. (2018). The pressures of obesity: The relationship between obesity, malnutrition and pressure injuries in hospital inpatients. Clinical Nutrition, 37(5), 1569– 1574. https: //doiorg. ezp. waldenulibrary. org/10. 1016/j. clnu. 2017. 08. 014 • Tayyib, N. , & Coyer, F. (2016). Effectiveness of pressure ulcer prevention strategies for adult patients in intensive care units: A systematic review. Worldviews on Evidence-Based Nursing, 13(6), 432– 444. https: //doi-org. ezp. waldenulibrary. org/10. 1111/wvn. 12177

Thank you!