Evidence-Based Practice Project Proposal

Type: EVIDENCE BASED PRACTICE

Subject: Issues in Nursing

Subject area: Nursing

Education Level: Masters

Length: 3 pages

Referencing style: APA

Preferred English: US English

Spacing Option: Double

Title: Evidence-Based Practice Project Proposal - Part A: Problem Statement

Instructions: the purpose of this assignment is to identify a problem, issue, or concern in the professional health care setting that is amenable to an evidence-based intervention. write a 500-750 word paper on your proposed problem for your evidence-based practice project proposal. complete the following: 1. identify a problem, issue or concern in a professional health care setting that you would like to address for your evidence-based practice project. research current literature for evidence-based solutions to ensure there is sufficient evidence to support your proposed topic. note: as you research, you may find there is very little research to support your topic and you will need to choose a new topic. remember, in order for this to be an evidence-based project proposal, you must have enough evidence to introduce this as a practice change. if you find that you do not have enough supporting evidence to change a practice, then further research would need to be conducted. 2. once you have determined there is sufficient research for your chosen topic, develop an initial reference list of five sources to demonstrate there is support for your evidence-based practice project. follow the "steps to an efficient search to answer a clinical question" box in chapter 3 of the textbook. refer to the "search method example" as the format in which to compile this data. the majority of references on your list should be research articles. however, national sources such as centers for disease control and prevention (cdc), national center for health statistics (nchs), department of health and human resources (hhs), or the agency for healthcare research and quality (ahrq) and others may be used when you are gathering statistics to provide the rationale for the problem. 3. provide a summary of the problem, include relevant background information, the current impact of the problem or issue in health care, and why it deserves attention. provide rationale and support using professional literature sources. 4. describe the practice setting where the identified issue or problem is occurring. explain the current impact to the practice setting and the potential consequence if the problem or issue were to continue. 5. identify the stakeholders who will be involved in this project. what organizations are concerned about, may benefit from, or are affected by this proposal? list the interested parties, patients, students, agencies, joint commission, etc. 6. state the purpose of the project and project objectives in specific, realistic, and measurable terms. the objectives should address what is to be gained. this will focus your picot statement as you develop and refine it over the next few weeks. remember, measurements need to be taken before and after the evidence-based practice is introduced to identify the expected changes. 7. summarize your proposed problem statement. a problem statement is a concise explanation of the problem or issue to be addressed and goals to be reached. prepare this assignment according to the apa guidelines found in the apa style guide, located in the student success center. an abstract is not required.

---

Also Read: Get Your Nursing Essay Writing Assistance

---

Focus: box 3 steps to an ef?cient search to answer a clinical question • begin with picot question—generates keywords. • establish inclusion/exclusion criteria before searching so that the studies that answer the question are easily identi?able. apply these criteria after search strategy is complete. • use subject headings, when available. • expand the search using the explode option (competency 3e, figure 3.1), if not automatic. • use available mechanisms to focus the search so that the topic of interest is the main point of the article. • combine the searches generated from the picot keywords and the subject head-ings using boolean connector and. • limit the ?nal cohort of studies with meaningful limits, such as language, human, type of study, age, and gender. • organize studies in a meaningful way using rms.

Structure: i was thinking something involving -infection control -wound care prevention as it relates to medical devices such as bipap, tubing ect. -or proning in patients with ards a topic with a large amount of available resources. thank you!

Evidence-Based Practice Project Proposal - Part A: Problem Statement
Student’s Name

Institutional Affiliation

Course Number: Course Name

Instructor

Date Due

Pressure Ulcer Management and Prevention in ICU Patients

Intensive care patients are at increased risk of developing pressure ulcers. Their increased risk is attributable to sensory and motor loss due to muscle relaxants, sedatives, and analgesics (Swan, 2018). Other risk factors like vasopressor infusion, immobility, perfusion, and age increase ICU patients’ susceptibility to developing pressure ulcers (Swan, 2018). Although pressure ulcer prevalence has attracted the government’s attention, they remain a dignificant source of mortality and morbidity. They also pose a significant financial burden on the healthcare system and individual patients due to prolonged hospital stay (Mervis & Phillips, 2019). Although pressure ulcers are a consequence of poor health or other medical conditions, they are preventable through moisture management, proper nutrition, frequent repositioning, and effective support surfaces.

The Identified Practice Setting Where the Problem is Occurring

Pressure ulcers are a prevalent complication in ICU (Intensive Care Unit) patients who are bedridden, ventilated, or sedated for long periods. According to He et al.(2016), mortality rates in ICU patients with pressure ulcers are 63% compared to 15% of those without the condition. The author attributes the difference to added psychological distress, pain, and morbidity often associated with social isolation and loss of independence among affected patients. If pressure ulcers are not addressed, they result in adverse consequences for the facility and the patient. For instance, pressure ulcer prevalence increases mortality and morbidity, especially in frail and elderly patients. They also increase healthcare expenditure, undermines patient’s quality of life due to significant impairment, discomfort, and pain (Moore et al., 2015; Sauvage et al., 2017). 

Accordingly, the Agency for Healthcare Research and the Centers for Medicare and Medicaid Services (CMS) recognize hospital-acquired pressure ulcers as a quality care metric. Therefore, hospitals are expected to prioritize pressure ulcer treatment and prevention because their reimbursement depends on their adherence to CMS implemented regulations in 2008 (Krupp & Monfre, 2015). For instance, facilities with high pressure ulcer incidents might be financially penalized for not meeting the quality standards. Additionally, patients might file legal lawsuits for being neglected by healthcare providers, leading to hospital-acquired pressure ulcers’ development. Therefore, healthcare settings should implement advanced strategies like turning schedules, education, risk assessment, providing audit feedback to staff, using lift teams, and evaluating healthcare providers’ knowledge regarding pressure ulcer treatment and prevention to address the consequences of the condition.

Stakeholders who will be Involved in the Project

The stakeholders that will be involved in the project are caregivers, healthcare staff, the infection control team, and the Joint Commission. The caregivers will benefit from the proposal because they will understand the importance of changing their loved ones’ position regularly, precisely every two hours, and use special pressure relieving cushions and mattresses to prevent pressure ulcers development. In contrast, the healthcare staff will benefit from the proposal because they should assess patient’s sore risk, take necessary measures to prevent pressure ulcers, and document risks. Otherwise, they might risk legal lawsuits if patients sue them for negligence. The Infection prevention and control team will benefit from the proposal because their goal is to control or prevent infections like pressure ulcers in the facility. Thus, they will help the healthcare staff and caregivers implement advanced strategies to prevent and manage pressure ulcers.

 The Joint Commission is concerned with the project because of the punitive measures in place for healthcare facilities that do not meet the expected quality standards. Therefore, the organization will help healthcare workers understand the importance of preventing pressure ulcers because the Centers for Medicare and Medicaid Services (CMS) in 2008 publicly declared that it would not cater for additional expenses cause by hospital-acquired pressure ulcers.  The use of evidence-based nursing practice prevents the costly treatment of pressure ulcers.

The Project Purpose and Objective

The project’s purpose is to increase awareness of the prevalence of hospital-acquired pressure ulcers among ICU patients, risk factors, and methods to prevent them. Therefore, the project objectives include

• Examining the risk factors for developing pressure ulcers
• Highlighting the consequences of not preventing and managing pressure ulcers
• Outlining the advanced strategies for preventing pressure ulcers
• Seeking support and funding to implement the proposed changes in the intensive care unit and the wider facility

The expected changes after introducing the evidence-based practice include reduced incidents of hospital-acquired pressure ulcers and associated consequences in the Intensive Care Unit and the healthcare facility.  Additionally, healthcare staff and caregivers being aware of the appropriate strategies for preventing and managing pressure ulcers. Similarly, patients should be satisfied with the quality of services offered by the facility.

Summary of Proposed Problem

Hospital-acquired pressure ulcers are a considerable healthcare challenge, to be precise among intensive care patients. The condition increases mortality and morbidity rates, undermines individuals’ quality of life due to social isolation and loss of independence.  Also, pressure ulcers contribute to psychological distress, lengthen hospital stays, and exert a considerable financial burden on patients and healthcare facilities. However, the condition is preventable through various strategies like moisture management, proper nutrition, frequent repositioning, healthcare education, and the use of effective support surfaces. Thus, this proposal aims to enhance effective pressure ulcer management and treatment by educating healthcare staff and other stakeholders on appropriate strategies to prevent the condition.

References

He, M., Tang, A., Ge, X., & Zheng, J. (2016). Pressure ulcers in the intensive care unit: an analysis of skin barrier risk factors. Advances in skin & wound care, 29(11), 493-498. https:/doi.org/ 10.1097/01.ASW.0000494779.66288.c9

Krupp, A. E., & Monfre, J. (2015). Pressure ulcers in the ICU patient: an update on prevention and treatment. Current infectious disease reports, 17(3), 11-15. https:/doi.org/ 10.1007/s11908-015-0468-7.

Mervis, J. S., & Phillips, T. J. (2019). Pressure ulcers: Prevention and management. Journal of the American Academy of Dermatology, 81(4), 893-902

Moore, Z., Johansen, E., Etten, M. V., Strapp, H., Solbakken, T., Smith, B. E., & Faulstich, J. (2015). Pressure ulcer prevalence and prevention practices: a cross-sectional comparative survey in Norway and Ireland. Journal of wound care, 24(8), 333-339.

Sauvage, P., Touflet, M., Pradere, C., Portalier, F., Michel, J. M., Charru, P., ... & Scherrer, B. (2017). Pressure ulcers prevention efficacy of an alternating pressure air mattress in elderly patients: E²MAO a randomised study. Journal of Wound Care, 26(6), 304-312.

Swan, J. (2018). Use of dermal gel pads in preventing and managing pressure ulcers in ICU: an audit. British Journal of Nursing, 27(20), S42-S47.

.