NURS FPX 6025 Assessment 3 Practicum and Scholarly Article

Practicum and Scholarly Article

This assessment summarizes the peer-reviewed article highlighting the impact of pressure injury prevention practices among nurses on avoiding Pressure Injury (PI) in adult patients. The authors of the peer-reviewed article, Gillespie et al. (2021), explore whether the evidence supports the effectiveness of repositioning schedules in PI prevention through PICO (Population, Intervention, Comparison, Outcome) parameters. My practicum speciality is managing elderly PI patients with critical care by implementing a PI care bundle to reduce PI incidences using the PICOT approach.

Summary of Evidence-Based Journal Article

In the peer-reviewed journal article ” Repositioning for pressure injury prevention in adults: An abridged cochrane systematic review and meta-analysis,” Gillespie et al. (2021), delve into the complexities of PI and determine the impact of repositioning schedules on PI incidence rate. They emphasized that clinical guidelines recommend repositioning to prevent PI in at-risk patients. They analyze the effect of different repositioning scheduling on patients’ outcomes and cost-effectiveness. Repositioning protocols use frequency such as every 2 hours, inclination, and position such as side, lying down, and upright to shift pressure between the human body and the supporting surface.

They assumed that repositioning can act as a preventative technique by lowering the length of tissue pressure and tissue hypoxia and reducing PI incidences. The study’s setting is adult PI patients in a critical care unit, serving a population facing various complications in managing PI during their hospital stay. To address PI challenges, through the PI prevention bundle, including repositioning schedules, the researchers implemented the PICO approach to identify the impact of repositioning schedules on the management of PI. The PICO provided results to patients during their care by lowering the incidence rate of PI. This feedback approach enabled healthcare providers to develop guidelines for patients’ needs to improve health outcomes.

NURS FPX 6025 Assessment 3 Practicum and Scholarly Article

The results showed significant PI risk reduction among adult PI patients. Eight study trials with 3,941 participants are conducted. Trials evaluated various repositioning frequencies and positioning protocols. Three trials with 1074 individuals evaluated 2- to 4-hour reposition scheduling, showing a risk ratio of 1.06. Two trials, including 252 individuals, assessed a 30- to 90-grade incline, indicating a threat ratio 0.62. Two trials included economic assessments with the nurse. The study evaluated repositioning expenses as $11.05 and $16.74 each day for 3-hour and 4-hour schedules, respectively, in comparison to the 2-hour schedule. 

Discussion on Article with a Peer

I came across a journal article written by Gillespie et al. (2021), published in the International Journal of Nursing Studies, which is pertinent and valuable in addressing the challenges of managing PI through nursing practice. The article highlights the impact of nursing practice in implementing PI prevention bundles like repositioning schedules and improving the health of adult patients with critical care. The study focuses on implementing the PICO approach for analysis of the impact of repositioning schedules by nurses among adult PI patients. The findings show that repositioning schedules compared to 2-hourly and 4-hourly shifting. The 2 hourly schedule improved health outcomes with reduced PI incidence rates. The use of PIOC led to decreased PI complications, and healthcare professionals can develop interventions based on these findings, which are cost-effective and improve PI outcomes. 

Another crucial aspect of the article addresses the cost-effectiveness of repositioning scheduling in PI care. Patients from different populations face numerous challenges, such as limited access to healthcare and low socioeconomic status, which can impact their ability to manage their health conditions (Kandi et al., 2022). Therefore, interventions like repositioning, scheduling, and education are essential for delivering cost-effective care to PI patients. My peer also shared comprehension about the significance of improving PI patients’ care through PI prevention bundle and self-care approaches as it allows for immediate adjustments to treatment plans during critical care of PI patients.

We discussed the hospital medical staff and patients’ opinions and experiences of PI practices and challenges and enablers to executing guidelines for PI prevention bundles, including repositioning, scheduling, and maintaining skin integrity (Wan et al., 2023). Moreover, Alshahrani et al. (2021), provide insight into efficient nursing interventions to avoid PI among critical care patients. If adopted according to the patient’s needs, PI care bundles reduce the PI rate. 

Reflection on Practicum Experience, Including Accomplishments and Challenges

During my practicum experience, I successfully implemented a PICO(T) intervention to reduce PI incidences and mitigate the risk of complications for elderly PI patients. I conducted patient education programs during the intervention to encourage self-management and raise awareness about the PI care bundle. The PIOC(T) intervention, the PI prevention bundle, effectively improved patient outcomes by reducing the PI incidence rate.

While implementing the intervention, we face resource constraints and discrepancies during collaboration with other healthcare professionals. Despite challenges like limited resources and time constraints in critical care settings, I remained dedicated to addressing PI management’s specific needs and challenges. By addressing clinical challenges in the chosen healthcare setting, the project aimed to optimize PI patient care, improve patient outcomes, and enhance the overall quality of care for elderly PI patients with critical care. This experience taught me the importance of empowering healthcare providers and patients with knowledge and tools to manage PI complications, contributing to improved health outcomes.

Completion of Practicum Hours

I accomplished 20 hours of my nursing practicum by employing the PICOT inquiry intervention, a PI care bundle, to reduce the incidence of PIs in the critical care of older patients. I acquire valuable experience and knowledge in PI patient care throughout this practice.  I applied the knowledge that I had gained from my academic courses. This experience has helped me comprehend the importance of PI care bundles and self-care protocols, the relevance of PIOC(T) intervention in minimizing PI complications, and the impact of current organizational resources used to address the problem.

Conclusion

My practicum experience has improved my comprehension of medical interventions and their influence on PI patient outcomes. Several peer-reviewed studies have acknowledged the advantages of PI prevention guidelines and self-care regimens. These guidelines aid in lowering PI risks and improving the health of older PI patients.

References

Alshahrani, B., Sim, J., & Middleton, R. (2021). Nursing interventions for pressure injury prevention among critically ill patients: A systematic review. Journal of Clinical Nursing, 30(15-16), 2151-2168. https://doi.org/10.1111/jocn.15709

Gillespie, B. M., Walker, R. M., Latimer, S. L., Thalib, L., Whitty, J. A., McInnes, E., & Chaboyer, W. P. (2021). Repositioning for pressure injury prevention in adults: An abridged cochrane systematic review and meta-analysis. International Journal of Nursing Studies, 120, 103976.‌ https://doi.org/10.1016/j.ijnurstu.2021.103976

NURS FPX 6025 Assessment 3 Practicum and Scholarly Article

Kandi, L. A., Rangel, I. C., Movtchan, N. V., Van Spronsen, N. R., & Kruger, E. A. (2022). Comprehensive management of pressure injury: A review. Physical Medicine and Rehabilitation Clinics, 33(4), 773-787.https://doi.org/10.1016/j.pmr.2022.06.002

Wan, C. S., Cheng, H., Musgrave-Takeda, M., Liu, M. G., Tobiano, G., McMahon, J., & McInnes, E. (2023). Barriers and facilitators to implementing pressure injury prevention and management guidelines in acute care: A mixed-methods systematic review. International Journal of Nursing Studies, 104557. https://doi.org/10.1016/j.ijnurstu.2023.104557