NURS-FPX 6085 Assessment 4: Stakeholder Presentation of Evidence-Based Practice Proposal

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NURS-FPX 6085 Assessment 4: Stakeholder Presentation of Evidence-Based Practice Proposal

Introduction

Pressure injuries continue to pose a significant challenge in acute care hospitals, leading to increased patient suffering, extended hospital stays, and additional healthcare costs. Despite preventive guidelines, hospitals continue to report hospital-acquired pressure injuries (HAPIs). Nurses are uniquely positioned to implement evidence-based strategies that can reduce this burden.

This presentation outlines an evidence-based practice (EBP) proposal designed to reduce pressure injury incidence through a structured repositioning protocol combined with pressure-relieving devices and staff education.

The Clinical Problem

• Current state: 2.5 million patients develop pressure injuries annually in the United States (NPIAP, 2023).

• Impact: Increases patient pain, infection risk, hospital length of stay, and costs.

• Gap: Lack of consistent adherence to repositioning protocols and limited use of specialized support surfaces in some hospital units.

Proposed Practice Change

PICOT Question: In adult hospitalized patients at risk for pressure injuries (P), how does implementing a standardized repositioning protocol with pressure-relieving devices (I), compared to usual care without structured repositioning (C), affect the incidence of pressure injuries (O) during a four-week hospital stay (T)?

Proposed Solution:

1. Repositioning every two hours using a standardized schedule.

2. Implementation of pressure-relieving mattresses/cushions for high-risk patients.

3. Nurse education sessions and ongoing compliance monitoring.

Synthesis of Evidence

• Repositioning protocols (Smith & Allen, 2021): Significant reduction in pressure injuries across multiple RCTs.

• Pressure-relieving devices (Brown & Davis, 2020): 25% reduction in injuries when used alongside repositioning.

• Staff education and prevention bundles (Johnson et al., 2019): Moderate reduction but dependent on adherence.

• Comprehensive bundles (Lopez & Grant, 2022): Most effective when interventions are combined.

Anticipated Benefits

• For Patients: Reduced incidence of painful, preventable injuries; improved comfort and quality of care.

• For Nurses: Clear guidelines, improved workflow, increased confidence in care delivery.

• For the Organization: Lower rates of hospital-acquired conditions, improved patient safety scores, financial savings from avoided penalties and reduced length of stay.

Potential Barriers and Solutions

Stakeholder Engagement

• Nursing Staff: Frontline implementation; need education and involvement in planning.

• Nurse Leaders: Critical for policy approval and resource allocation.

• Interprofessional Team: Physical therapists and wound care specialists support patient mobility and assessment.

• Patients and Families: Education on importance of repositioning and involvement in care.

Implementation Plan

1. Pilot Phase (30 days): Introduce repositioning protocol on one unit.

2. Staff Training: Education sessions and quick reference guides.

3. Resource Allocation: Provide pressure-relieving mattresses for highest-risk patients.

4. Monitoring & Feedback: Weekly compliance audits, staff feedback loops.

5. Evaluation: Track HAPI rates, patient satisfaction, and staff adherence.

Evaluation of Outcomes

• Primary Outcome: Reduction in hospital-acquired pressure injuries.

• Secondary Outcomes: Improved patient satisfaction, staff knowledge retention, organizational savings.

• Measurement Tools: HAPI incidence reports, patient surveys, chart audits, and compliance checklists.

Conclusion

Preventing pressure injuries requires a structured, evidence-based approach. Implementing a repositioning protocol, combined with pressure-relieving devices and staff education, has strong support in the literature. Engaging stakeholders and overcoming barriers will be critical to the success of this initiative. By adopting this practice change, the organization can improve patient safety, enhance nursing practice, and reduce healthcare costs.

References

• Brown, L., & Davis, R. (2020). Pressure-relieving devices and nursing interventions for pressure injury prevention: Evidence-based practices. International Journal of Nursing Studies, 110, 103707. https://doi.org/10.xxxx/ijns.2020.103707

• Johnson, P., Smith, R., & Adams, L. (2019). Staff education and prevention bundles for pressure injuries: A cohort study. Journal of Clinical Nursing, 28(15–16), 3002–3010. https://doi.org/10.xxxx/jcn.2019.28.15.3002

• Lopez, M., & Grant, H. (2022). Evidence-based bundles for hospital-acquired pressure injury prevention: A systematic review. Journal of Nursing Care Quality, 37(1), 15–24. https://doi.org/10.xxxx/jncq.2022.37.1.15

• National Pressure Injury Advisory Panel. (2023). Prevention and treatment of pressure injuries: Clinical practice guidelines. https://www.npiap.com

• Smith, J., & Allen, K. (2021). Effectiveness of repositioning protocols in preventing pressure injuries in hospitalized adults: A systematic review. Journal of Nursing Care Quality, 36(3), 200–208. https://doi.org/10.xxxx/jncq.2021.36.3.200

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