Preventing Pressure Ulcers in Bedridden Patients: A New Best Practice - Essay Sample

Introduction

The chosen problem to address is pressure ulcers on bedridden patients at my workplace. I am part of the wound team at my organization, and it has been a challenge to prevent the patients from developing pressure ulcers due to their incontinent and bedridden condition. I have identified a new best practice that should be implemented in the organization to decrease the likelihood of the patients from developing hospital-acquired wounds. The new best practice to perform is to position the patients in a way that will reduce at minimum the development of pressure ulcers. In implementing this innovation, it will require following several steps, understand how change comes in the workplace, the impacting policies and procedures and evidence-based practice as supported by past literature.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Order now

The Steps of Implementing the New Practice

Effective execution of the new practice in the workplace will require following the four stages of innovation proposed by Rogers (1983) including knowledge, persuasion, decide to adopt the innovation and consistent application with evaluation (Mohammadi, Poursaberi, & Salahshoor, 2018). Roger's diffusion of innovation theory explained how the phases contribute to change in the workplace. In the first step, knowledge takes place when nurses become aware of the new practice. I will disseminate information about the innovation to the nurses through interpersonal contacts to provide information about the benefits of appropriate positioning of bedridden patients and teach them about effective positioning strategies.

Change in the workplace to adopt and implement the new practice will also require persuading the nurses. The persuasion stage will entail explaining the use of physical methods to prevent the development of pressure ulcers for bedridden patients. I will convince the nurses that wound can be prevented through physical practices than pharmacological approaches by frequently changing the position of the patient, and massaging the prone parts to pressure ulcers development. In their study, Jocelyn, Thiara, Lopez, and Shorey (2017) established that the turning frequency of bedridden patients prevents the occurrence of hospital-acquired pressure ulcers. This evidence-based practice reflects the appreciation of nursing observation and applying interventions other than pharmacological.

Implementing the new best practice will require the nurses to decide on adopting innovation. In the third stage, I will engage them into at least three trials for them to see the intervention working for various patients. The trial basis will encourage and convince the nurses to implement the new practice as intended. Deciding to implement the innovation will be followed by the fourth step whereby I will follow up on the consistent application and evaluating the results to confirm the success of the new intervention.

Policies and Procedures Influencing the Innovation Adoption

The policies and procedures that may impact on the implementation of the new practice include agency policy, procedure manuals, and the views of the nurses. During the persuasion stage, the perceived policy regarding research-based nursing practice influences the adoption behavior of innovation among nurses in the hospital (Clarke, 1995). Further, in the third and fourth steps, organizational barriers may also impact on my effort to implement the new practice. Also, the nurse's perception of authority and the need for the administration in implementing a change of the nursing practice within the workplace may inhibit the adoption of the innovation. According to Clarke (1995), the perception of the potential users of a change influences the rate of adoption. When the new best practice is an advantage to the patient and compatible with the values and experiences of the nurses, then, it is easy to adopt the innovation. The nurses can understand and implement the requirements, test and evaluate the benefits as well as demonstrate the likeliness of the findings to bring a change in the nursing practice. In the new method, I understand that problems are inevitable. However, I will assist the nurses in progressing from one stage to another in a logical and timely way. It will enable them to pass through all the four stages fast and without much inhibition to the innovation.

Why the Change Needs to Occur

The development of pressure ulcers for bedridden patients has been on the increase in the workplace. I have noticed this to be a lasting problem and requiring the long-term intervention that will reduce the costs of treating the wounds for the patients. Preventing the development of pressure ulcers has more benefits that outweigh the costs of implementing the new best practice. Therefore, the change needs to occur within the nursing practice at my organization to prevent bedridden patients from getting pressure ulcers and reduce the costs of treatment. According to Yoshikawa, Maeshige, Sugimoto, Uemura, Noguchi, and Terashi (2015), the positioning of bedridden patients reduces interface pressures over the sacrum and great trochanter. The rotation of the hip joint is a recommended way of positioning bedridden elderly patients to reduce the development of pressure ulcers at the sacrum and the great trochanter. Supine positions for the sacrum and neural area for the hip-joint minimizes the occurrence of pressure ulcers and ultimately lowering the cost of treatment for the patient. Jocelyn et al. (2017) recommend the use of positioning as an intervention for reducing pressure ulcers among bedridden patients in hospitals. Increasing the tuning frequency of the adult patients bound on their beds is an evidence-based practice that informs future nursing practice. The change needs to occur by increasing the turning frequency and duration for positioning the bedridden patients for effective prevention of developing pressure ulcers. The new best practice will make the work of nurses more efficient and treatment cost-effective for the hospital and the patients.

Conclusion

In conclusion, the new best practice to implement positioning approaches for bedridden patients will be competent to prevent the development of pressure ulcers. I will follow the four stages of diffusion innovation to implement the change within the workplace. I anticipate a few challenges from the organization, policies, and nurses when implementing the innovation. The new best practice is validated by research, and this explains why the change needs to occur.

References

Clarke, H. (1995). The Nightingale legacy: Child health 2000. International Pediatric Nursing Conference.Jocelyn, C., Thiara, E., Lopez, V., and Shorey. S. (2017). Turning frequency in adult bedridden patients to prevent hospital-acquired pressure ulcer: A scoping review. International Wound Journal, 1-12. DOI: 10.1111/iwj.12855

Mohammadi, M. M., Poursaberi, R., & Salahshoor, M. R. (2018). Evaluating the adoption of evidence-based practice using Rogers's diffusion of innovation theory: a model testing study. Health promotion perspectives, 8(1), 25-32. doi:10.15171/hpp.2018.03

Rogers, E.M. (1983). Diffusion of innovations. (3rd ed.). New York: The Free Press.

Yoshikawa, Y., Maeshige, N., Sugimoto, M., Uemura, M., Noguchi. M and Terashi, H. (2015). Positioning bedridden patients to reduce interface pressures over the sacrum and great trochanter. Journal of Wound Care. 24(7). https://doi.org/10.12968/jowc.2015.24.7.319