Introduction
Pressure ulcers are generally present in patients that are unable to move due to a particular condition freely and sometimes after surgical intervention. Although easily prevented most of the time, amounts of patients experiencing pressure ulcers continue to grown since the last decade steadily. There are a number of guidelines that nurses may consult to research ways to prevent and treat pressure ulcers. However, it is most necessary not to let them develop in patients, as the treatment would require additional resources and time. Therefore, considering the fact that pressure ulcers cases continue to increase in numbers, health care institutions need to adopt a set of measures to prevent this condition in patients. Some of the solutions are presented by Sullivan and Schoelles (2013). The authors mention repositioning the patient, providing sufficient and proper nutrition, and moisturizing sacral skin. Therefore, these measures are required to be included in the focused plan. The desired outcomes would then be related to preventing pressure ulcers from forming altogether.
Change Model Overview
Stevens (2013) describes the ACE Star model of knowledge transformation as the one highlighting “barriers encountered when moving evidence into practice and designating solutions grounded in EBP” (para. 13). Basically, there are five steps that need to be carried out in order for evidence to be translated into practice. The first step requires performing the research itself. The evidence is gathered and then summarized in the second step. The summarized information is then translated into certain guidelines. These guidelines are then adopted by health care practitioners with an evaluation of outcomes and the process of exploiting the guidelines themselves.
It is considered necessary for nurses to use the ACE star model to adopt changes because this model allows evidence to be fully transported into practice without losing its initial value or specificity. Additionally, this model is relatively simple to use and, therefore, allows for rapid evidence translation.
Define the Scope of the EBP
Pressure ulcers create a great number of obstacles in terms of recovery and treatment mostly because methods of treating pressure ulcers require additional resources and time spent as well as a number of certain approaches. This issue becomes problematic mostly due to the fact that there is always a possibility for health care units to deal not only with initial hospitalization cause but with occurring pressure ulcers as well.
As reported by Bauer, Rock, Nazzal, Jones, and Weikai (2016), pressure ulcers are a common condition that increases patient morbidity and causes excessive amounts of government expenditures to cover the damage done to the health care system. The authors state that patients with pressure ulcers have at least 7.1% morbidity rates. Additionally, an excessive amount of resources is spent annually with as much as $75 million being spent on both prevention and treatment of pressure ulcers. Each year, almost three million people in the U. S. develop pressure ulcers (“Pressure Sore Statistics,” 2013; Berlowitz et al., 2014). Naturally, due to the reasons mentioned above, this creates a significant burden on the health care system which prevents health care practitioners from carrying out their duties in full or affects their quality of service.
Stakeholders
The list of stakeholders required to implement an adequate change would require representatives from various departments (at least one nurse and one physician) and a chief nurse executive.
Determine Responsibility of Team Members
Essentially, such composition of the team would be sufficient to both promote the change and adopt proper conditions in which the implemented changes will operate. The roles of the team’s members would then be to develop necessary adjustments and monitor their implementation. Additionally, team members will be able to provide coverage of the rationale behind the changes in various segments of the institution.
Evidence
The evidence supporting the change mainly consists of the publications elucidating the prevalence of pressure ulcers problem in the modern health care system. The strength of this research consists of its persuasive nature and the fact that it allows grasping the problematic nature of the topic fully.
Summarize the Evidence
The primary interventions suggested by the authors are for a team of medical workers possessing sufficient experience in treating open wounds to help the patients as soon as required. Such a team may consist of doctors, nursing practitioners, and other professionals who work in governmental medical institutions (Moore, Webster, & Samuriwo, 2015). Therefore, this team may be created from already trained personnel. However, since the chances that there would be enough experienced employees to form a team are relatively small, it would be necessary to create such a group using employees that will volunteer to receive additional responsibilities.
Develop Recommendations for Change Based on Evidence
Recommendations will then include the formation of such a team to operate quickly in case of an emergency. The pilot program would include training and expertise sharing amongst the employees to prepare a highly skilled team of specialists that would provide this type of service along with their primary responsibilities in a health care institution.
Translation
Action Plan
The steps would then be:
- Preparing a training program;
- Selecting employees that are willing to participate in the initiative;
- Train volunteers to reach proper expertise;
- Implement additional payment for the team.
Depending on the willingness of executives to cooperate and the motivation of employees to take part in the program, it may take about five to nine months. A plan to evaluate results would include maintaining a statistic of pressure ulcers cases that were successfully solved by the team.
Process, Outcomes Evaluation and Reporting
The desired outcome would be a significant decrease in cases of severe and post-clinic pressure ulcers cases. These will be measured via the statistic mentioned above directly to the key stakeholders.
Identify Next Steps
Ideally, this program will show sufficient improvements regarding pressure ulcers cases and will be considered valuable on a larger scale. Other units and facilities as a whole might then consider adopting this program as well. This will also ensure a permanent nature of the adoption.
Disseminate Findings
The findings will be reported both internally and externally via the mentioned above statistics and the group members’ reports. Based on this evidence, the effectiveness of the program might be evaluated and regarded as a possible source of changes for other institutions and publicity in general.
Conclusion
Pressure ulcers create a significant burden on the health care system across the globe. This burden is stipulated by the fact that the health care system requires additional funding, and practitioners often spend much more resources and time to deal with this condition in conjunction with the initial cause of hospitalization. The change model suggests training a group or an institution’s employees to treat pressure ulcers as soon as possible. The ACE star model’s most important aspect that would influence the adoption of this program is the evaluation of the outcomes. This is required the most to ensure the program’s proper functioning and its maintenance.
References
Bauer, K., Rock, K., Nazzal, M., Jones, O., & Qu, W. (2016). Pressure ulcers in the United States’ inpatient population from 2008 to 2012: Results of a retrospective nationwide study. Ostomy Wound Management, 62(11), 30-38.
Berlowitz, D., Lukas, C. D., Parker, V., Niederhauser, A., Silver, J., Logan, C., … Zulkowski, K. (2014). Preventing pressure ulcers in hospitals. A toolkit for improving quality of care. Web.
Moore, Z., Webster, J., & Samuriwo, R. (2015). Wound-care teams for preventing and treating pressure ulcers. Cochrane Database of Systematic Reviews, 9(1), 4-22.
Pressure sore statistics. (2013). Web.
Stevens, K. (2013). The impact of evidence-based practice in nursing and the next big ideas. OJIN: The Online Journal of Issues in Nursing, 18(2).
Sullivan, N., & Schoelles, K. M. (2013). Preventing in-facility pressure ulcers as a patient safety strategy. A systematic review. Annals of Internal Medicine, 158(1), 410-416.