Abstract
Practice Problem: Hospital-Acquired Pressure Injury (HAPI) is a serious problem in patient care and has deleterious implications for the patient and the healthcare system. A 530-bed acute care hospital in the Rio Grande Valley identified a similar challenge and implemented a HAPI preventive program. This evidence-based practice (EBP) project was guided by the following PICOT question: In the Intensive Care Unit/Medical Intensive Care Unit (ICU/MICU) patients aged 18 and older, does a pressure preventive bundle, compared to routine pressure injury care, reduce the incidence of pressure injury, within 21 days?
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The reviewed literature supported evidence of effective use of a pressure injury preventive bundle in reducing the incidence of pressure injuries in an acute care setting. Seven articles met the inclusion criteria and were used for this literature review. Intervention: The evidence-based pressure injury preventive bundle are interventions that included consistent skin risk assessment and the application of a group of clinical practice guidelines composing of moisture management, optimizing nutrition and hydration and minimizing pressure, shear, and friction that were proven to prevent the occurrence of pressure injuries. Post-implementation findings showed that there was no reduction in the incidence of HAPI but significant decrease in the severity of the pressure injury from Stage two to Stage one. The staff education, training, and implementation of an evidence-based bundle intervention to prevent the incidence of HAPI proved a positive outcome on reducing the pressure injury severity from Stage Two pressure injuries to Stage One pressure injuries.Prevention of Hospital-Acquired Pressure Injuries HAPI.
Importance and Need for Standardized Early Ambulation HAPI Prevention Protocols in Post-Surgical Patients
A pressure injury is localized damage to the skin and or the tissue often over the bone due to pressure from surfaces the area rests on. As such, the blood supply is reduced in the area, which then reduces oxygen flow. The cells start to die due to insufficient circulation of air and blood (McKenzie et al. 2018). Pressure injury often develops in intraoperative patients due to reduced sensation of cell injury that is always the defense mechanism for the body. Prevention of Hospital-Acquired Pressure Injuries HAPI.
Pressure injuries that develop at the operating rooms account for more than fifty per cent of all hospital-acquired pressure injury in hospitals. Injuries that occur within seventy-two hours after surgery indicate that the damage during the procedure, as such lengthy procedures, are associated with pressure injuries in post-surgical patients. Additionally, approximately ten per cent of a patient population who undergo procedures longer than three hours are likely to develop HAPI. Risk factors of HAPI include immobility, loss of sensation, shear or friction (McKenzie et al. 2018). HAPI results in poor prognosis, prolonged hospitalization and increased cost of health care for the patient. Prevention of Hospital-Acquired Pressure Injuries HAPI.
Implications for Nursing Practice
Effective Risk Assessment
A standardized protocol provides tools that can be used to assess a patient’s risk of developing a pressure injury. The most resourceful tool in the evaluation of pressure injury is the Braden scale. The tool assesses patient’s mobility, friction and shear, sensory perception, nutrition, activity and moisture. These elements are scored under a particular range specific to each (Chaboyer et al., 2015). Prevention of Hospital-Acquired Pressure Injuries HAPI.Finally, the score of each component is computed. Results obtained will then define the integrity of the skin and the inner tissues. As such, notable risk of interferences with the skin integrity necessitates an action as well as identifiable injury. (Rowe et al., 2018) A Braden scale is widely used because it is easily applicable in practice. It is also comprehensive and ensures that all the risk factors to pressure injury are evaluated. It is reliable and enhances the validity of the examination every time it used. Nurses can care for post-surgical by use of Braden scale and reduce the risk and prevalence of hospital-acquired pressure injuries. After that, promote a good prognosis and reduce the length of the hospital stay. Prevention of Hospital-Acquired Pressure Injuries HAPI.
Improved Quality of Care and Health Outcomes
Standardized protocols for the prevention of HAPIs comprise four domains of Nelson
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