The chosen change plan is connected to Preventing Pressure Ulcer Occurrence in hospitalized patients at Intermediate Care Units. Achieving positive change regarding pressure ulcers is crucial since it is an injury that breaks down the integrity of the skin or any other underlying tissue. Pressure ulcers of pressure sores are predominantly caused by stays at the hospital because a part of the skin is placed under some pressure hence reducing blood flow to that part of the skin (Smith et al., 2013).
Hard and Soft Elements of Change
The 7S model developed by McKinsey is one of the most effective frameworks for implementing change in a range of professional areas; therefore, it can be used for the chosen change plan. The model is divided into the hard and soft elements of change. Hard elements of change refer to what can be physically seen or done while soft elements are not tangible and can be complicated to define (Sherwin, n.d.). To establish hard and soft elements of the change, it is important to outline the primary strategy, structure, systems, skills, staff, style, and shared value.
Strategies for implementing change in patients with pressure ulcers include the assessment of barriers and guidelines on the organizational level before implementing the prevention initiative or intervention. It is also important to conduct regular evaluations on the organizational level and provide feedback to stakeholders (National Pressure Ulcer Advisory Panel, 2014). Lastly, a multi-dimensional approach should be developed for eliminating the existing barriers and enhancing the implementation of change.
The structure of pressure ulcers change will include four components: an organization should have a pressure ulcers prevention policy; nursing professionals should receive appropriate education and training; necessary information about the condition should be available to patients and caregivers; the treatment protocol should address all components of effective treatment and prevention (National Pressure Ulcer Advisory Panel, 2014). Systems necessary for successful change implementation include social and financial support systems, specific pressure ulcer classification systems, and risk assessment systems.
Skills required for successful change implementation include professional medical skills, communication, and interpersonal skills, leadership skills, and team development skills. Staff for change implementation will include medical professionals responsible for caring for patients, organizations’ leaders, and change stakeholders. The cultural style for change will be grounded on ethical conduct within an organization. The shared value for change is a common goal to prevent pressure ulcer occurrence in hospitalized patients at Intermediate Care Units.
Facilitators and Barriers for the Change
Preventing pressure ulcer occurrence in hospitalized patients at Intermediate Care Units is a task that can potentially influence the decrease in the rates of the condition. Therefore, each element of change can either facilitate the success of the plan or limit it. According to research conducted by Hartmann, Solomon, Palmer, and Lukas (2016), prevention of pressure ulcers are greatly facilitated through the use of formal structures and leadership prioritization in facilities where performance improved.
However, in health facilities where performance declined, the implementation of leadership strategies created a barrier for the change. Financial support can also become a component of change that will facilitate its success. Apart from financial support, successful change implementation can be facilitated by formal structures (teams and committees) that develop specialized care strategies for Intermediate Care Units.
Effective communication skills and strategies among the nursing staff in Intermediate Care Units can have a two-dimensional impact on the change. If the nursing staff exhibits a lack of effective communication skills, the change implementation will be hindered. On the contrary, effective communication among team members will become the greatest facilitator of change compared to financial support or efficient leadership skills. The shared value of change is an aspect that can either limit or facilitate the change based on the professional environment in the care unit.
Story to Support the Change
Pressure ulcer prevention in hospitalized patients is a complex and multi-dimensional issue that requires the involvement of many interconnected practices and care systems (Hartman et al., 2016). According to Homerton University Hospital (2014), approximately seven hundred thousand patients suffer from the condition each year.
Intermediate Care Units are expected to deal with pressure ulcers regularly since patients hospitalized for long periods are under high risk of developing the condition. Preventing pressure ulcers is a major challenge that costs the country billions of dollars each year, which is nothing compared to the severe pain patients are forced to experience.
Therefore, the change in pressure ulcer occurrence is urgent, and there is no time to wait for another chance because it may never come. All participants of the change plan, including key stakeholders, should remember that the majority of patients with pressure ulcers are the elderly that face major challenges with their physical abilities.
A story of my grandfather, a person that enjoyed his life, may become a great example to illustrate what patients suffering from pressure ulcers may go through. When accepted to the hospital with the diagnosis of chronic kidney disease, he was optimistic about the recovery. However, after going through surgery, he developed some complications that forced him to stay in bed for weeks.
I remember my grandmother telling me that there were always no nurses around; they were too occupied by other patients that required, even more attention than my grandfather. As a result of no physical activity, my grandfather developed pressure ulcers, which caused him severe pain and discomfort. In my opinion, the ulcers had a greater impact on his psychological well-being than the kidney disease ever had. A person that enjoyed his life and was always optimistic about any outcome faded into a man that just wanted the pain to stop. In my experience, I can say that severe pain injures the mind to a larger extent than it injures the body.
There is no “appropriate” time for implementing a pressure ulcer prevention program because the time is always “now”. If there is anyone who deserves to live a pain-free life is the elderly who gave the future generations all they had, who worked hard for us living a peaceful and full life. It is high time to give back support and care as a gesture of appreciation, love, and respect.
In my opinion, the change plan to prevent pressure ulcer occurrence in hospitalized patients should be one of the many steps to ensure that the elderly live a comfortable and pain-free life. We should incorporate strategies for promoting physical activity, healthy dieting, and social interactions. By combining the 7S model with the common goal of reducing the occurrence of pressure ulcers in hospitalized patients, we will be able to show that we respect and value the well-being of every person that needs our care.
References
Hartmann, C., Solomon, J., Palmer, J., & Lukas, C. (2016). Contextual facilitators of and barriers to nursing home pressure ulcer prevention. Adv Skin Wound Care, 29(5), 226-238.
Homerton University Hospital. (2014). Pressure ulcers.
National Pressure Ulcer Advisory Panel. (2014). Prevention and treatment of pressure ulcers: Quick reference guide.
Sherwin, L. (n.d.). Managing change toolkit.
Smith, B., Totten, A., Hickam, D., Fu, R., Wasson, N., Rahman, B., Motu’apuaka, M., & Saha, S. (2013). Pressure ulcer treatment strategies: A systematic comparative effectiveness review. Annals of Internal Medicine, 159(1), 39-50.