Presentation on HAPU Management and Control in the Healthcare Settings

PICOT: In acute care patients at risk for acquiring hospital acquired pressure ulcers (HAPU), does the development of bedside skin nurse champions program, improve care delivery, over 8 weeks?

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Presentation

Topic: HAPU management

Focus: Acute care

Type: Poster

Abstract Title: DNP project implementation and dissemination

Abstract:

Introduction: This DNP project focuses on HAPU management and control in the healthcare settings. The most significant steps of a project are implementation and dissemination. For a successful project, a smooth transition is required from implementation to dissemination.

Findings and discussion

Project implementation and dissemination follows four phases which are Plan, Do, Study and Act (PDSA) (Ihi.org, 2017). Project implementation occupies the first two phases (plan and do). During plan phase, all the essentials of the project are identified including the budgetary requirements of the project. For the Do phase, the project kicks off in the setting, and this includes recruitment of project stakeholders and more so training them about the project. The Study and Act phase are used in project dissemination where the identified practices are introduced in the training and the healthcare setup (Ihi.org, 2017).

During project implementation, it is the phase where visions and the plans of the projects are shared. In this phase according to the DNP essentials, the nurse practitioners start by identifying the problem and any other solution that has been put in practice (American Association of Colleges of Nursing, 2006). The nurse practitioners are also competent enough to analyze and criticize the available literature concerning the existing problem. For this project, the existing problem is the increased incidences of hospital-acquired pressure ulcers. After identifying the available measures that have been taken to reduce the high incidence of pressure ulcers the implementation phase also incorporates identification of the existing gaps in the management of HAPU (American Association of Colleges of Nursing, 2006). Evidence-based practice is then implemented to ensure effective management of this problem. Additionally, the goal of project implementation is to improve the existing practice to ensure a better outcome (Woodhouse & Graham, 2014).

According to Bergquist-Beringer, Derganc, & Dunton, (2009), the literature concerning pressure ulcers identifies organizational factors that contribute to quality improvement. The factors identified include effective communication structures, personal involvement and accountability, multidisciplinary involvement, and effective quality data systems. The above factors are essential in improving the patient outcomes as well as project success. Agencies like CINHAL and PubMed are essential in delivering the available literature on HAPU management. According to Bergquist-Beringer, Derganc, & Dunton, (2009), the role of a skin care champion is to promote evidence-based pressure ulcers. In the DNP project, the skin care champions embrace teamwork, improving outcome, and ensuring HAPU prevention to the bedside. According to Carson, et al., (2012), collaborative approach in HAPU management is an effective measure to ensure there is a success in the project to reduce the incidence. From the collaborative approach care bundles and evidence-based practice is enhanced in the project implementation.

Orsted, Rosenthal & Woodbury, (2009) have identified another supportive implementation essential, where these researchers have identified the implementation essentials of the HAPU management program. Implementation of the pressure ulcers awareness program is one of the key steps in this DNP project. Awareness involves identification of the prevailing issues in HAPU management and the introduction of the education process in managing the problem as well. Increasing awareness is the key step during DNP project implementation. During project implementation, another management measure that is put place is the education of both the caregivers and the patients (Warner, et al., 2017).

Concerning the DNP project dissemination, it is a phase where the project evidence-based is identified to be used in practice for a better patient outcome. Project dissemination regarding HAPU management starts with the implementation of education programs to ensure full competence in managing patients and mitigating the incidence (Anderson, Knestrick, & Barroso, 2015). During the dissemination program, the DNP project stakeholders have the duty to ensure the gaps in patient management are taken good care of. Following the dissemination of project evidence-based measures, an evaluation tool comes in place during the dissemination phase of the DNP project where the participants are examined on their competence concerning the training. The OSCE tools are also used in the dissemination phase to evaluate the sustainability of the practice change initiated by the project (Abdulghani, Ponnamperuma, & Amin, 2015). In conclusion, DNP project implementation and dissemination is a continuous process that requires follow-up in every phase of the project.

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References

Abdulghani, H. M., Ponnamperuma, G., & Amin, Z. (2015). An essential guide to developing, implementing, and evaluating Objective Structured Clinical Examination (OSCE). Singapore : World Scientific

American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. Washington, D.C: The Association.

Anderson, B. A., Knestrick, J. M., & Barroso, R. (2015). DNP capstone projects: Exemplars of excellence in practice. New York : Springer Publishing Company.

Bergquist-Beringer, S., Derganc, K., & Dunton, N. (January 01, 2009). Embracing the use of

skin care champions. Nursing Management, 40, 12, 19-24.Carson, D., Emmons, K., Falone, W., & Preston, A. M. (January 01, 2012). Development of pressure ulcer program across a university health system. Journal of Nursing Care Quality, 27, 1, 20-27.

Harris, J. L., Roussel, L., Thomas, P. L., & Dearman, C. (2016). Project planning and management: A guide for nurses and interprofessional teams. Burlington, MA : Jones & Bartlett Learning.

Ihi.org, (2017). Plan-Do-Study-Act (PDSA) Worksheet. (2017). Ihi.org. Retrieved 20 March 2017, from http://www.ihi.org/resources/Pages/Tools/PlanDoStudyActWorksheet.aspx

Orsted, H. L., Rosenthal, S., & Woodbury, M. G. (January 01, 2009). Pressure ulcer awareness and prevention program: a quality improvement program through the Canadian Association of Wound Care. Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society, 36, 2.)

Warner, J., Ann, R. M., Hajduk, G., & Collavo, J. (January 01, 2017). Best Practices for Pressure

Ulcer Prevention in the Burn Center. Critical Care Nursing Quarterly, 40, 1, 41-48.Woodhouse, L., & Graham, K. (January 01, 2014). Meeting targets in pressure ulcer prevention

in the community by collaborating with industry. British Journal of Community Nursing, 2014, 14-20.