Answer for NRS 493 Capstone Project Change Proposal Presentation for Faculty Review and Feedback Introduction & Purpose of the Presentation

Patient safety and quality of care are critical to attainment of better outcomes in different care settings. Hospital acquired infections and adverse conditions like hospital acquired pressure injuries (HAPIs) have negative effects on patient care quality and safety. Each year, over 2.5 million people get HAPIs with close to 60,000 succumbing to these injuries. HAPIs cost the health system close to $11 billion every year. Studies are categorical that implementing pressure injury prevention (PIP) care bundle can reduce and prevent the prevalence of HAPIs in various settings, especially in critical and progressive care units (AHRQ, 2019). Therefore, through the PIP care bundle approach, nurses get interventions based on evidence to prevent these injuries as they can develop patient-centered strategies to reduce their occurrence. The purpose of this presentation is to showcase an evidence-based practice (EBP) capstone project aimed at reducing and preventing HAPIs in critical care and progressive care units.

Clinical Problem/ Issue

A study by Pitman (2019) shows that the prevalence of HAPIs is between 3% and 8.3% among patients in critical care units. Pressure injuries range in their severity, from open wounds to advanced wounds that include deep skin tissue breakdown. HAPIs affect over 2.5 million patients in critical care and progressive care units with costs amounting to $11 billion (Mortada et al., 2020). Again, these injuries are associated with close to 60,000 deaths each year as well as comorbidities. Patients in critical care settings with limited mobility and delicate nature are more susceptible to these injuries because of their nature and immobility (Tervo-Heikkinen et al., 2021). The implication is that they are at an increased risk for HAPIs and require interventions based on evidence like the PIP care bundle approach.

Proposed Intervention

HAPIs lower the quality of care and patient outcomes. Nursing care entails leveraging best practices to prevent adverse events or aspects and improve patient care. The proposed intervention is to implement pressure injury prevention (PIP) care bundle that comprise various strategies to manage HAPIs, especially among patients in critical care settings (Rivera et al., 2019). The PIP care bundle is patient-centered approach and encourages patient education to reduce and prevent HAPIs in settings that they occur.

The implementation of PIP care bundle entails having strategies that leverage technological interventions and innovations to deliver care, and staff-focused coordination and implementation. The use of PIP care bundle approach would entail having staff training on identification of pressure injuries and their effective management, patient-centered approaches to offer information and strategies that patients can leverage to reduce their susceptibility to HAPIs and effective interdisciplinary coordination to improve outcomes. The implementation requires effective organizational leadership and management support to enhance the possibility of attaining expected outcomes based on the available resources.

Evidence-Based Literature to Support the Project

HAPIs are a significant health concern resulting in more than 60,000 deaths each year. Nurse need knowledge and awareness about their prevalence and prevention measures. The present literature is founded on search strategies agree that PIP care bundle is important to prevent an reduce the prevalence of HAPIs. The reviewed articles used different research methods and designs. The articles also had diverse objectives, goals and aims. However, they majorly focused on the prevalence of HAPIs and ways to prevent and reduce their occurrence through nurse knowledge and implementation of patient-centered interventions.

The reviewed literature demonstrates consistent support for the use of evidence-based practice to implement these interventions in different care settings, especially in critical care areas. The study by Yilmazer et al. (2022) shows that having PIP care bundle improves nurses interventions for managing these injuries. Edsberg et al. (2022) also emphasize the role of nurses in implementing better patient-centered strategies to reduce the prevalence of these injuries while Coyer et al. (2022) shows that the implementation is critical to the attainment of safety and quality care. Lindhardt et al. (2019) emphasize that nurses require knowledge and effective strategies to care for the geriatric population with the issue. Again, the article by Amirah et al. (2021) explores the role of positive attitudes by nurses in implementing PIP care bundle to prevent and reduce HAPIs.

The existing literature is categorical that sufficient and consistent evidence supports the use of PIP care bundle to reduce and prevent occurrence of pressure injuries acquired in hospitals. Pitman et al. (2019) an Qaddumi et al. (2019) all illustrate the significance of these interventions on patients and nurses with the aim of improving quality of care. The care bundle ensures that nurses have guidelines and integrates measures tailored at meeting patient’s unique needs. These guidelines enhances nurses’ competence to handle patient concerns and requirements based on their needs.

Objectives of the Project

The proposed project entails four critical objectives concerning the topic of interest. These include increasing awareness among critical care nurses about HAPIs and their adverse effects, preventing and reducing their prevalence in critical care units, and improving patient’s and provider’s safety through quality care delivery (Hinic, 2021). The fourth objective is to implement EBP intervention in the management of HAPIs to improve overall patient outcomes (Floyd et al., 2021). The change project will entail effective implementation of the proposed intervention to reduce and prevent the occurrence of HAPIs by 50% using care bundle components tailored to meet patient needs.

Required Resources

The implementation of the capstone project requires sufficient and effective interventions and resources. These resources are based on the strategic plan and include human expertise from different healthcare providers who include nurses, nurse leaders, and change champions (Ruppel et al., 2022). The project requires sufficient human resources through better collaboration among different professionals through an interdisciplinary team. The second resource needed entail materials and access to sufficient information and databases (Lam et al., 2020). These materials will offer evidence and guidelines concerning what the team should implement to improve the attainment of set goals (Floyd et al., . The implication is that the interventions will entail integration of EBP strategies based on patient condition to improve care provision.

Anticipated Measurable Outcomes

The measurable outcome measures for the project would include reducing the prevalence of HAPIs in these settings by 50% within three months to enhance attainment of quality patient care, and increase nurses’ knowledge and awareness of these infections (Zhang et al., 2021). The measurable outcomes will also entail having appropriate interventions through the PIP care bundle to improve overall care implementation and safety measures for different health populations in these critical care settings

The project’s anticipated outcome measures also include improvement of patient safety based on their needs and preferences, integration of EBP interventions in nursing practice setting and attainment of value-based purchase model. The implementation of this capstone project is expected to improve overall care delivery and quality of patient services received by the different individuals in critical care scenario.

Evaluation of Intervention

The evaluation of the project will be founded on strategic plan developed for the initiative to illustrate effectiveness of care bundle. Gathering data and analyzing it concerning the prevalence of HAPIs before and after the implementation will be core activities in this project. The team will gather this data through satisfaction surveys and questionnaires to patients and nurses in the critical care settings. Summative assessment of HAPIs will determine the effectiveness of the care bundle approach.

The evaluation will also comprise chart audits for all patients at increased risk for HAPIs with informatics nurses being in charge of data analysis and interpretation. The team will also communicate the findings thorough making relevant presentations to demonstrate overall effectiveness of the project on the targeted audience (Kim, M et al., 2020). Communication will also be critical to critique the ability of the project to meet set objectives.

References

Amirah, M., Rasheed, A., Parameaswari, P., Awajeh, A., Issa, M., & Abdallah, M. (2019). Pressure injury prevalence and risk factors among

adult critically ill patients at a large intensive care unit. Journal of Intensive & Critical Care, 5(2), 9.

Coyer, F., Cook, J. L., Doubrovsky, A., Campbell, J., Vann, A., McNamara, G., … & Fulbrook, P. (2022). Implementation and evaluation of

multilayered pressure injury prevention strategies in an Australian intensive care unit setting. Australian Critical Care, 35(2),

143-152. https://doi.org/10.1016/j.aucc.2021.03.005

Floyd, N. A., Dominguez-Cancino, K. A., Butler, L. G., Rivera-Lozada, O., Leyva-Moral, J. M., & Palmieri, P. A. (2021). The

effectiveness of care bundles including the Braden scale for preventing hospital acquired pressure ulcers in older adults

hospitalized in ICUs: A Systematic review. The Open Nursing Journal, 15(1): 74-84. DOI: 10.2174/1874434602115010074

Hinic, K. (2021). Evidence-based Virtual Learning Experiences For The Clinica