Evidence-based pressure ulcer prevention for a neuroscience intensive care unit

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Melissa W Kaufman

USA

: J Nurs Patient Care

Abstract

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Statement of Problem: Preventative strategies may reduce the number of patients who develop Hospital-Acquired Pressure Ulcers (HAPUs). The effects of HAPUs may include an extended patient hospital stay, social isolation, and possible death. The purpose of this Evidence-Based Practice (EBP)change project was to decrease the number of reported HAPUs by 50% over three consecutive months in a neuroscience Intensive Care Unit (ICU). Methods: Data on patients who developed HAPUs in the neuroscience ICU over a three-month time interval were first reviewed. After evaluating the data, an EBP change project on HAPUs was developed and implemented with nursing personnel who worked in the neuroscience ICU. Components of education included dietary instruction, specialty bed in services, demonstrations of wound care products, and practice in proper patient positioning and turning of clients. During the three months of implementation, patients in specialty beds were routinely assessed for proper positioning and routine turning every two hours. Foley bag tubing and intubation tube holders were assessed for proper placement as these devices can increase skin pressure on the bedbound client. Throughout this project, nursing personnel completed tests on HAPU content to reinforce learning. Results: HAPU totals were less when personnel received instruction. However, the 50% threshold decrease over three consecutive months while the EBP change project was implemented was not met. The number of reported HAPUs decreased by 1 during the implementation of the project, but 7 still occurred during the 12-week period despite staff education. In addition, the Pressure Ulcer (PU) stage for each client prior to and during the implementation of the EBP change project was not compared. Conclusion: Educating nursing personnel on pertinent HAPU topics increases their knowledge and ability to deter pressure ulcer development

Biography

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Melissa W Kaufman has over 30 years of experience working in health care. Since 1993, she has been a Certified Wound, Ostomy and Continence Nurse. Her dedication to educating peers and patients continues today. The above figure displays a quality improvement project that she developed for nurses at a local trauma center. Her educational figure is applicable to people of all ages as people are living longer and with more chronic health conditions.

E-mail: kaufman44m@gmail.com