NRS 493 Capstone Project Topic Selection and Approval

Sample Answer

Nursing practice and profession is founded on the intent to enhance patient outcomes and satisfaction through the delivery of quality care using evidence-based practice (EBP) interventions. Based on collaboration with the preceptor in the practicum site, one issue or problem of concern is hospital acquired pressure injuries or ulcers. Studies (Tervo-Heikkinen et al., 2021; Smith et al., 2018; 2022; Mortada et al., 2020) demonstrate that hospital acquired pressure injuries are common yet preventable conditions that impact care delivery and quality patient outcomes.

The Agency for Healthcare Research and Quality (AHRQ) asserts that over 2.5 million individuals develop pressure ulcers while in hospitals (Pitman et al., 2019). The purpose of this paper is to present the identified Capstone project topic for subsequent approval. The paper addresses the setting or context of the issue, describes its prevalence and effects, significance of the problem to nursing practice and provides a proposed solution.

Setting

The setting and context of the problem, hospital acquired pressure injuries or ulcers, is hospital, especially in critical and progressive care units. The critical care unit serves 20 patients who require close monitoring and changing of positions because of immobility and delicate nature of their condition. Critically ill patients often show poor tissue tolerance because of hypo-perfusion, poor nutrition and immobility as well as insufficient oxygenation of tissues. These individuals have a ten-fold higher risk for getting hospital acquired pressure injuries (HAPIs).

Description of the Issue

Despite several an array of preventive approaches, hospital acquired pressure injuries (HAPIs) continue to be prevalent, particularly in critical and progressive care units. According Pitman et al. (2019), the prevalence rates of HAPIs in critical care units range from 3% to as high as 53% in comparison to 2% to 8.3% in medical-surgical units. Despite the significant variation, these injuries prevent increased cost burden and possible comorbidities that lengthens one’s stay in hospitals and other selected facilities like long-term care areas (Alderden et al., 2019).

Pressure injuries range in severity, from early injuries without open wounds to advanced wounds that entail deep skin breakdown as well as bones, muscles and even tendon. As such, treating pressure injuries at different stages of their diagnosis is critical to attaining better patient outcomes.
Impact of the Hospital Acquired Pressure Injuries As stated, HAPIs are critical quality care issues that affect millions of patients leading to deaths and increased cost of care. Organizations consider HAPI rates as a measure of the quality of nursing care offered and evaluates the financial penalties when they happen (Rivera et al., 2019).

The implication is that these adverse events cause suffering and poor patient outcomes yet most of them are preventable or avoidable. As stated earlier, hospital acquired pressure injuries (HAPIs0 affect over 2.5 million patients in the U.S. and cost between $9 and $11 billion, with a further 60,000 people dying because of direct effects of having these conditions.

Significance of the Problem

HAPIs lower the quality of care and patient outcomes. Nursing practice leverages best practices, especially in preventive measures to improve patient care. As such, this issue is important for nurses to develop preventive measures and work collaboratively in the setting where it occurs (Rivera et al., 2019). Nursing practice focuses on better interventions to offer best care but having these injuries leads to increased cost of care and susceptibility to other comorbidities.

Proposed Solution

The proposed solution to reduce the prevalence of HAPI in critical care unit is having pressure injury prevention (PIP) bundle that standardizes the preventive measures. Studies show that using PIP bundle allows providers to implement a host of strategies that include patient education and even technological interventions to reduce and eliminate the incidence of HAPIs (Gaspar et al., 2019; Coyer et al., 2022). The use of PIP bundle includes having staff-focused interventions as well as patient-focused strategies that reduce the susceptibility of patients to HAPIs.

Conclusion

Hospital acquired pressure injuries are a critical concern for healthcare organizations and providers. These injuries lead to over 60,000 deaths every year in the United States and cost about $11 billion. Nursing practice is about offering quality care to patients. Therefore, implementing PIP bundle allows nurses to reduce the prevalence of HAPIs, especially in critical care units (CCUs).

References

• Alderden, J., Drake, K. P., Wilson, A., Dimas, J., Cummins, M. R., & Yap, T. L. (2021). Hospital acquired pressure injury prediction in surgical critical care patients. BMC Medical Informatics and Decision Making, 21, 1-11. DOI https //doi.org/10.1186/s12911-020-01371-z
• Coyer, F., Cook, J. L., Doubrovsky, A., Campbell, J., Vann, A., McNamara, G., … & Fulbrook, P. (2022). Implementation and evaluation of multilayered pressure injury prevention strategies in an Australian intensive care unit setting. Australian Critical Care, 35(2), 143-152. https //doi.org/10.1016/j.aucc.2021.03.005
• Gaspar, S., Peralta, M., Marques, A., Budri, A., & Gaspar de Matos, M. (2019). Effectiveness on hospital‐acquired pressure ulcers prevention a systematic review. International wound journal, 16(5), 1087-1102. https //doi.org/10.1111/iwj.13147
• Mortada, H., Malatani, N., Awan, B. A., & Aljaaly, H. (2020). Characteristics of hospital acquired pressure ulcer and factors affecting its development a retrospective study. Cureus, 12(12). DOI 10.7759/cureus.11992
• Pittman, J., Beeson, T., Dillon, J., Yang, Z., & Cuddigan, J. (2019). Hospital-acquired pressure injuries in critical and progressive care avoidable versus unavoidable. American journal of critical care, 28(5), 338-350. DOI 10.4037/ajcc2019264.
• Rivera, J., Donohoe, E., Deady-Rooney, M., Douglas, M., & Samaniego, N. (2020). Implementing a Pressure Injury Prevention Bundle to Decrease Hospital-Acquired Pressure Injuries in an Adult Critical Care Unit An Evidence-Based, Pilot Initiative. Wound Management & Prevention, 66(10), 20-28. DOI 10.25270/wmp.2020.10.2229
• Smith, S., Snyder, A., McMahon Jr, L. F., Petersen, L., & Meddings, J. (2018). Success in hospital-acquired pressure ulcer prevention a tale in two data sets. Health Affairs, 37(11), 1787-1796. https //doi.org/10.1377/hlthaff.2018.0712
• Tervo‐Heikkinen, T. A., Heikkilä, A., Koivunen, M., Kortteisto, T. R., Peltokoski, J., Salmela, S., … & Junttila, K. (2022). Pressure injury prevalence and incidence in acute inpatient care and related risk factors a cross‐sectional national study. International wound journal, 19(4), 919-931. https //doi.org/10.1111/iwj.13692