Wound Management and Prevention Assignment Paper

Wound Management and Prevention Assignment Paper

NURS 6843: PICOT Worksheet

Learner Name: Jessica Camille

The purpose of the PICOT statement is to guide the systematic search of healthcare databases to find the best available evidence to answer the question. In the PICOT worksheet, you will formulate a one-sentence PICOT statement and provide a full discussion of your PICOT statement including a discussion of the population, intervention, comparison, outcome, and timeframe below. Utilize Chapter 2 in Melnyk & Fineout-Overholt. Include a reference list in the APA 7^th edition. Turnitin is not required for this assignment. Wound Management and Prevention Assignment Paper

***Full-text article permalink is REQUIRED for all articles***

One sentence PICOT statement:

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For staff working in the intensive care unit (P), how does the implementation of a pressure ulcer prevention bundle (I) compared with usual care (C) impact the incidence of pressure ulcers (O) in 8 weeks (T)?

Population

Fully elaborate on the population. What are the primary characteristics they share? What inclusion and exclusion criteria will you use? Include age range, gender if applicable, and certain disease or disorder (i.e. diabetes, Schizophrenia, etc). Wound Management and Prevention Assignment Paper

Staff working in the adult intensive care unit (ICU). Those working in pediatric ICUs and critical care units will be excluded. Also, the researcher will exclude staff caring for adults in other critical care units.

Intervention

Provide full elaboration to explain exactly what evidence-based intervention you plan to utilize in your evidence-based practice project. The intervention is found to be the most reasonable alternative to current practice and is supported by significant primary research evidence.

Pressure ulcer prevention bundle: Risk assessment, repositioning, skincare, nutrition and hydration, and monitoring and reporting of pressure ulcer incidence. Research studies have identified prevention bundles as an evidence-based intervention for reducing the incidence of pressure ulcers or injuries. Wound Management and Prevention Assignment Paper An example is Rivera et al. (2020) who found pressure injury prevention bundle reduced the incidence of pressure injuries in adult CCUs. Another study was by Tilmazer and Tuzer (2019), who evaluated the validity of the pressure ulcer prevention bundle and realized it increased staff compliance and improved patient outcomes. The two studies have adopted clinical practice recommendations for pressure ulcer prevention and treatment by the American College of Physicians (ACP) (Qaseem et al., 2015).

Comparison

The comparison is what you want to compare the intervention against. In evidence-based practice projects, the comparison is “compared to current practice”. In evidence-based practice change projects, a new evidence-based change is implemented against what the usual standard of care is currently. Wound Management and Prevention Assignment Paper

Compared to usual care. Currently, nurses check on the ICU patients during rounds and reposition them accordingly. While repositioning is one of the interventions in the pressure ulcer prevention bundle, the method cannot reduce the incidence of pressure as they have multifactorial causes (Rivera et al., 2020).

Outcome

Discuss a specific, measurable outcome to evaluate your project. What outcome are you expecting from the intervention that will resolve the main problem? Specifying the outcome will assist you in focusing the search for relevant evidence. Ideally, you will find evidence supporting the evidence-based intervention that examined the same outcome. Wound Management and Prevention Assignment Paper

Incidence of pressure ulcers. The expected outcome is a reduction in the incidence of pressure ulcers within the specified timeframe of the evidence-based practice project as in Rivera et al. (2020).

Time

The time it takes for the intervention to achieve the outcome or the time over which the populations are observed for the outcome to occur. It must be a feasible timeframe for the intervention to take effect in your population.

8 weeks. The intervention will be implemented in 8 weeks and the outcome monitored and reported. Pressure ulcers/injuries occur within a short timeframe. Therefore, eight weeks is adequate for implementing the pressure ulcer prevention bundle and monitoring the incidence after the intervention (Tilmazer & Tuzer, 2019). Wound Management and Prevention Assignment Paper

Original Research articles: Full-text article permalink is REQUIRED for all articles.	List two original research articles (meet criteria on the levels of evidence chart) that support the intervention:
	1. 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 and Prevention, 66(10), 22-29. https://doi.org/10.25270/wmp.2020.10.2229. The article meets the description of Level III evidence based on Melynk and Fineout-Overholt’s (2023) evidence hierarchy.
	2. Tilmazer, T., & Tuzer, H. (2019). Pressure ulcer prevention care bundle: A cross-sectional, content validation study. Wound Management and Prevention, 65(5), 33-35. https://www.hmpgloballearningnetwork.com/site/wmp/article/pressure-ulcer-prevention-care-bundle-cross-sectional-content-validation-study. Wound Management and Prevention Assignment Paper The article is a Level III evidence based on Melynk and Fineout-Overholt’s (2023) evidence hierarchy.
Include Clinical Practice Guidelines or major agency recommendations, if applicable.	American College of Physicians Pressure Ulcer Treatment Practice Guidelines (2015). Qaseem, A., Humphrey, L. L., Forcea, M. A., Starkey, M., & Denberg, T. D. (2015). Treatment of pressure ulcers: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 162(5), 370-379. https://doi.org/10.7326/m14-1568. Wound Management and Prevention Assignment Paper

References

Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.), pp.189-228. Philadelphia, United States: Wolters Kluwer.

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 and Prevention, 66(10), 22-29. https://doi.org/10.25270/wmp.2020.10.2229.

Tilmazer, T., & Tuzer, H. (2019). Pressure ulcer prevention care bundle: A cross-sectional, content validation study. Wound Management and Prevention, 65(5), 33-35. https://www.hmpgloballearningnetwork.com/site/wmp/article/pressure-ulcer-prevention-care-bundle-cross-sectional-content-validation-study. Wound Management and Prevention Assignment Paper

PICOT Statement

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Literature Support

Current ICUs oftentimes still face challenges with pressure ulcers, which are persistent and severe. Numerous prevention bundle approach was used to manage the problem of pressure ulcer and the outcomes of its feasibility have been investigated. The fact that ICU pressure ulcer preventions bundles according to, and revealed in two research studies, proves their effectiveness. Wound Management and Prevention Assignment Paper

Articles Chosen

As the study was reported in the Wound Management and Prevention by Rivera et al. (2020), the bundle of pressure injury prevention measures in a critical care setting for adults were put in place. The study of their group explains the feelings, that bundles are importantly effective in decreasing the appearance of hospital-acquired pressure injuries, and which belongs to Level III evidence. Besides, in the same journal article, Titmazer and Tuzer (2019) conducted another study, in which they tried to find content validity of a pressure ulcer preventive care package. Alongside that, our team seeks to promote the comprehension of preventative bundles and their role in preventing ICU patients from pressure ulcers as well as the evidence from this study, which is of Level III. The consequent studies highlight the importance of conducting evidence-based prevention strategies as highlighted in the PICOT statement, capable of reducing the number of pressure ulcers which result among the critical care unit staffers between an eight-week period.Top of Form Wound Management and Prevention Assignment Paper

Key Search Terms and Primary Type of Evidence

The following are the main search terms that were used: “pressure ulcer prevention measures,” “intensive care area,” “pressure injury avoidance,” “conventional care vs., monitoring procedure,” and “incident of pressure ulcer.” Datasets are the main type of found research during my literature exploration on pilot experiment.

Limitations Identified in the Literature

The literature in some studies presents small sample sizes, in others it can be observer data which relies on self-disclosed data and preliminary studies that did not use random assignment are among literature’s limitations. The limitations of having variable methodologies, defined outcomes and confounding factors may hinder the reliability and generalizability of the results. Wound Management and Prevention Assignment Paper

Johns Hopkins Table Level and Quality Guide

John Hopkins evolver table of level and quality guide is allocating both the read articles as Level III. Although such studies have some drawbacks, their remarkable contributions include the ability to show that certain pressure ulcer prevention methods do indeed work and reduce the number of pressure sores seen in ICUs. Wound Management and Prevention Assignment Paper

Conclusion

Supported by research testing by proven technologies and measures, pressure ulcer prevention bundles can also diminish the pressure ulcer rates in Intensive Care Units (ICUs). Interventions like risk assessment, repositioning, skincare, nutrition and hydration management and tracking of and reporting pressure ulcer incidence are mostly elements of these bundles. The efficiency of this model for use in the intensive care units has been tested recently in two comprehensive studies. Rivera et al. (2020) reported a significant drop in new PIs in several trial projects that they conducted in adult CCU after establishing the DEPFI successful implementation. Tilmazer and Tuzer (2019) validation research content looks valid through the lens of preventative bundles, which function as a shield against pressure ulcers in ICU patients. Nevertheless, the data reveals that although its limitations i.e. small sample size and the fact that most of the data used in observational studies is usually self-reported there is still a noticeable reduction in pressure ulcer cases in intensive care units when the prevention bundles are implemented. Wound Management and Prevention Assignment Paper

In this discussion, you will be asked to share the literature support that you have identified to support your evidence-based practice project. You have demonstrated literature support for the practice problem and elaborated on the significance of the problem, as well as developed a compelling PICOT statement to drive inquiry. The next step is to continue to search for the best current evidence. It is imperative that the intervention has demonstrated an impact on the outcomes from your PICOT within the literature search.

**Please share your PICOT at the top of your discussion post response** Wound Management and Prevention Assignment Paper

Complete any revisions to the PICOT or literature base from previous assignments and discussions based on the feedback of your professor.

Please share the permalink for two primary research studies that you plan to use to support your PICOT. Utilize the articles from the PICOT worksheet assignment. If you were asked to review your PICOT or literature from the PICOT DRAFT and FINAL assignments, please complete the required revisions before completing this assignment. They must be quantitative. Do not include qualitative literature to support your project. All literature must be contemporary (published within the last 5 years) and found from credible and reliable sources.

Consider these reflective questions/statements as you formulate your post:

1. What are the key search terms utilized for your search? Wound Management and Prevention Assignment Paper

2. What is the primary type of evidence that you found in your search?

3. Were there any limitations that you identified in the literature shared this week?

4. Use the Johns Hopkins Table Level and Quality Guide to share the evidence level and quality for the two primary research studies included in your discussion this week.

Engage in meaningful dialogue with substantive posts, as well as incorporate at least three (3) different scholarly sources each week – include an in-text citation for each source using APA 7th edition formatting. Review the Discussion Guidelines and Rubric document for more information. Wound Management and Prevention Assignment Paper

Wound Management and Prevention Assignment Paper