The principal aim of healthcare organizations is to ensure the provision of quality care that is directed towards keeping the patients safe. As Hirpa et al. (2020) outlined, healthcare is shifting to value-based care models emphasizing the quality of services. This essay explores the application of evidence-based practices, research undertakings, and PI strategies to healthcare facilities in the treatment of pressure ulcers while focusing on proactive measures, organizational culture, and data-driven approaches to improve patient safety and provide quality care.
The Issue and Associated Challenges
Pressure ulcers are a common patient safety concern in the healthcare industry. Pressure ulcers are manifestations on the skin and the deeper underlying tissues. (Gefen et al., 2020). They tend to form in the lower back, hips, ankle, and heel (Premkumar et al., 2021). The etiology for most pressure sores is the direct pressure from an object that can last longer. Although they can occur to anyone, people who stay in bed longer or sit in chairs or wheelchairs are more susceptible. Liu et al. (2023) found that the hospital-borne bedsore attributed to the pressure reached 17.4%. In the United States, 2.5 million people in acute care facilities are affected by pressure ulcers annually (Padula & Demarmente, 2019). Pressure ulcers create various medical burdens such as infection, pain, longer hospitalization, and even death. The patients brought to healthcare facilities mostly cannot move. Therefore, they must depend on nurses to turn or move them according to the previously determined schedule to prevent their skin deterioration. Hence, pressure ulcer incidences are a nurse-sensitive indicator that shows the quality of care in a particular hospital.
How EBP, Research, and PI would be Utilized to Address the Issue
EBP is a problem-solving approach that implements the reliable findings of research studies, the patient’s perception, and the doctor’s practice together (Drisko & Grady, 2019). This method uses important information to provide treatment advice that will greatly reduce the risk of the problem’s reoccurrence. PI is a process used to study how an issue can be reached to carry out an intervention and assure high performance in the future. To search for a solution to the issue of pressure ulcers, PI would be employed to observe the quantity of pressure ulcers present on the ward. Once the evidence shows that the number of pressure ulcers is higher than expected, a study will be conducted to determine the underlying cause of the increase in cases (Drisko & Grady, 2019). Once the root cause has been found, an evaluation of the EBP based on prior knowledge is conducted to form the best practices or strategies to use in the unit to deal with the identified root causes. The next step captures the number of cases of pressure ulcers that have occurred, and subsequent effectivity measures are used to determine whether the interventions were useful.
The PI or QI Process to Apply
The PI process that would be implemented is the Six Sigma quality improvement mechanism. This model was selected because it is a tool that can minimize the possibility of mistakes being made, consequently improving the quality of care and the level of patient satisfaction. It achieves this by applying the DMAIC (define, measure, analyze, improve, and control) towards finding solutions (Godley & Jenkins, 2019). It involves determining the needs and risk of pressure ulcer patients and then assessing ulcer occurrence; gathering all the data associated with these measures; optimizing resource usage; improving the guidelines for the treatment to ensure quality care; and, at last, sustaining the newly developed standards.
Data Sources
In order to gather information about the incidence of pressure ulcers, all the medical records of patients admitted to the ward will be reviewed. A special emphasis will be put on checking if pressure ulcer risk was examined using assessment for each patient on admission and how frequently high-risk patients were shifted for position changes. This health indicator would be compared to the total number of patients at high risk admitted to the unit and later developed pressure ulcers while under care there. The other information source could be collecting the total number of pressure ulcers on the ward and determining whether those patients had already been categorized as high-risk. Frequency graphs gauge frequency and show the shape of the underlying probability distribution. The success rate of the interventions will be assessed by determining the changes that have taken place in the patients by using the outcome measures.
How Data will be Captured and Disseminated
A cause-and-effect diagram would be preferable to provide the target audience with the data. These diagrams are crucial in identifying the common causes of a problem and relating the cause to the output of a process and the predictability of a process (Xu & Dang, 2020). The ward’s overall number of pressure ulcers and their degree of risk could either appear as a bar graph or a frequency diagram to demonstrate the contrast in the number of patients between those who were identified and those who were not. Data dissemination refers to the activity of providing or sending out statistics to end users. The results and findings obtained from this initiative will be shared in two ways: results will be published in national and local magazines. Also, information will be delivered via social media or on the platforms of an organization where not only the nurses but also the patients can easily access them.
Organizational Culture Considerations
The culture in an organization may play a significant role in the success of any care-based campaign aimed at pressure ulcer prevention. The organizational culture constitutes an entrenched group of values, norms, expectations, and conventions that determine the activities of all the institution members (Canning et al., 2020). Pressure Ulcer prevention measures will only be successful if the staff, who are responsible for accurately assessing patients and using the pressure ulcer bundle and planned interventions for every patient every day, are entrusted with this duty (Canning et al., 2020). Another organizational culture consideration is the development of successful relationships with stakeholders and organizations that play different intervention-level roles.
Conclusion
Strategic approaches are required to reduce bed sore cases. PI strategies, including Six Sigma, research, and evidence-based programs, can minimize pressure ulcer occurrences and enhance patient outcomes for institutional healthcare based on scientific knowledge. Lastly, setting a favorable organizational culture that connects all these initiatives is beneficial in controlling pressure ulcers and improving the patient’s general status.
References
Canning, E. A., Murphy, M. C., Emerson, K. T., Chatman, J. A., Dweck, C. S., & Kray, L. J. (2020). Cultures of genius at work: Organizational mindsets predict cultural norms, trust, and commitment. Personality and Social Psychology Bulletin, 46(4), 626-642. http://faculty.haas.berkeley.edu/chatman/papers/Canning_Murphy_Emerson_Chatman_Dweck_2020_PSPB.pdf
Drisko, J. W., & Grady, M. D. (2019). Evidence-based practice in clinical social work. Springer. https://core.ac.uk/download/pdf/326762682.pdf
Gefen, A., Brienza, D. M., Cuddigan, J., Haesler, E., & Kottner, J. (2022). Our contemporary understanding of the etiology of pressure ulcers/pressure injuries. International Wound Journal, 19(3), 692-704.https://onlinelibrary.wiley.com/doi/abs/10.1111/iwj.13667
Godley, M., & Jenkins, J. B. (2019). Decreasing wait times and increasing patient satisfaction: a lean six sigma approach. Journal of Nursing Care Quality, 34(1), 61–65. https://journals.lww.com/jncqjournal/FullText/2019/01000/Decreasing_Wait_Times_and_Increasing_Patient.11.aspx
Hirpa, M., Woreta, T., Addis, H., & Kebede, S. (2020). What matters to patients? A timely question for value-based care. PLoS One, 15(7), e0227845. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0227845
Liu, H., Zhang, Y., Jiang, H., Yao, Q., Ren, X., & Xie, C. (2023). Outcomes of hospital-acquired pressure injuries and present-on-admission pressure injuries: A propensity score matching analysis. Journal of Tissue Viability, 32(4), 590–595. https://www.sciencedirect.com/science/article/pii/S0965206X23000967
Padula, W. V., & Delarmente, B. A. (2019). The national cost of hospital‐acquired pressure injuries in the United States. International wound journal, 16(3), 634-640. https://onlinelibrary.wiley.com/doi/pdf/10.1111/iwj.13071
Premkumar, S., Girithar, T. A., Kumar, P. N., Saimothish, R., Malani, V. A., & Jacob, R. (2021, March). 5-Position 4-actuator automated bed to prevent bed sores. In Journal of Physics: Conference Series (Vol. 1831, No. 1, p. 012024). IOP Publishing. https://iopscience.iop.org/article/10.1088/1742-6596/1831/1/012024/pdf
Xu, Z., & Dang, Y. (2020). Automated digital cause-and-effect diagrams to assist causal analysis in problem-solving: a data-driven approach. International Journal of Production Research, 58(17), 5359-5379.https://www.researchgate.net/profile/Zhaoguang-Xu/publication/339230775_Automated_digital_cause-and-effect_diagrams_to_assist_causal_analysis_in_problem-solving_a_data-driven_approach/links/5ec24b8f92851c11a8704967/Automated-digital-cause-and-effect-diagrams-to-assist-causal-analysis-in-problem-solving-a-data-driven-approach.pdf
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