Posted: August 3rd, 2022

APA , Nursing

Note: Please follow the grading rubric.

  • Communication with stakeholders
  • -20% (fully identify the actions that a nurse leader would take with regard to communication with stakeholders).

  • Training
  • – 20% (fully identify the actions that a nurse leader would take with regard to training.

  • Budget
  • – 20% (fully identify the actions that a nurse leader would take with regard to budget.)

  • Change management
  • – 20% (fully identify the actions that a nurse leader would take with regard to change management including a specific change management theory that is appropriate to the project.)

  • Authority
  • – 15% (fully identify the actions that a nurse would take with regard to authority.)

    Communication – 5% ( assignment is concise with exceptional attention to detail and free of errors.)

    To do:

    Consider the nurse leader’s role at each stage of the project that you did about pressure ulcers for me.

    Identify the actions that a nurse leader would take regarding the following:

      Communication with stakeholders
      Training
      Budget
      Change management

    • Include a specific change management theory that is appropriate to this project.
    • Authority

    Format your assessment as one of the following:

    • 14- to 20-slide Microsoft® PowerPoint® presentation 
    • The slides should only contain essential information and as little text as possible. Do not design a slide presentation made up of long bullet points. Use speaker notes to convey the details you would give if you were presenting. See create speaker notes from Microsoft® for more help.
    • Please do not forget speaker notes.

    APA FORMAT and 4 references.

    Thank you.

    Healthcare Problem Presentation

    By: Vannelyn Oriel

    1

    Problem Definition

    In this case, pressure ulcers is the problem that was identified.

    Pressure ulcers refer to injuries to the skin and underlying tissue and this is can be attributed to prolonged pressure on the skin.

    Today, pressure ulcers is increasingly becoming a major health concern globally.

    Healthcare systems worldwide continue to direct resources towards helping patients effectively and efficiently manage pressure ulcers.

    Pressure ulcers is becoming a major health concern globally.
    It root cause is prolonged pressure on the skin.
    It mostly affects patients in hospitals.
    Few studies have focused on assessing this healthcare problem.
    It is a pattern that I would like to change to improve quality.
    2

    Pressure Ulcers
    According to data from the Agency for Healthcare Research and Quality (AHRQ), more than 2.5 million people in the U.S. develop pressure ulcers annually.
    Pressure ulcers especially among patients recovering in hospitals bring pain.
    The healthcare problem also leads to increased health care utilization.
    There is increase risk for serious infection among patients in hospitals.

    Overall, documented cases of pressure ulcers has been on an upward trend globally.
    In most cases, pressure ulcers develop among patients who have a specific health condition that limits their ability to change positions.
    3

    Symptoms and Causes of Pressure Ulcers
    There exist various symptoms and causes of pressure ulcers.
    The first symptom is unusual changes in a patient’s skin color or texture.
    Increased tenderness of skin areas.
    Swelling can be observed.
    Pus-like draining is another symptom.
    Bedsores can be categorized into different stages that cause pressure ulcers.

    Common areas for pressure ulcers
    Buttocks.
    Back of legs, and arms where a patient rests against the chair.
    Shoulder and spine.
    4

    Risk Factors
    Immobility for example, assuming a patient in hospital is using a wheelchair, they would apply pressure to specific parts such as buttocks leading to pressure ulcers.
    Incontinence where a patient’s skin becomes susceptible due to extended exposure to urine and stool.
    Poor diet and nutrition leading to lack of vitamins and minerals that can lead to a healthy skin.
    Patients with diabetes also have high risk of experiencing pressure ulcers.

    Pressure ulcers if not well managed and treated among patients can lead to complications such as cancer, and bone and joint infections.
    5

    Description of the Problem
    Pressure ulcers is a major health concern in today’s nursing practice.
    Despite so, it is largely preventable in nature.
    The management of pressure ulcers relies on its severity.
    A study by Surg, 2015 established that cleaning of wound, using antibiotics, and undergoing reconstructive surgery were the present treatment options for pressure ulcers (Surg, 2015).
    However, there exist newer treatment options such as cell therapy, wound therapy and wound therapy.

    Nurses have a vital role to play in prevention and management of pressure ulcers among patients.
    It has today become a patient safety issue.
    For this reason, effective preventive and management strategies signifies a marker of quality of care that should be leveraged by nurses.
    6

    What could happen if the problem is not addressed
    As a nurse, if the problem of pressure ulcers among patients in hospitals is not effectively addressed, then the consequences can be unimaginable.
    First, it can lead to a significant damage of tissues on a patient’s body and they may eventually die.
    Most often, pressure ulcers do not lead to death.
    However, it can lead to a decline in health of an individual.
    Treatment of pressure ulcers can be costly thus negatively impacting on the economic well-being of patients and their families.

    Consequences of pressure ulcers can be significant for example, severe skin damage, reduced body immunity, increased cost of treatment and even death if not well-managed.
    7

    Relevance of the problem
    It is important for individuals especially those in nursing career to be aware and know more about pressure ulcers.
    A research anchored on knowledge and practice of nurses towards prevention of pressure ulcer found it to be inadequate among them (Nuru et al., 2015).
    It presents a huge challenge as many nurses lack knowledge and practice of effectively and efficiently preventing and managing pressure ulcers.
    Understanding pressure ulcers will help in determining how it impacts an patient’s well-being in hospital.

    It is important to appreciate the fact that there is a huge gap in terms of knowledge and practice regarding pressure ulcers among nurses globally.
    For this reason, there is need for an intervention towards equipping nurses with the requisite support systems to help them effectively prevent and manage pressure ulcers.
    Eventually, this will lead to desirable health outcomes among patients.
    8

    A real-life scenario of Pressure Ulcers Knowledge and Practice among Nurses
    To effectively describe the problem, there was need to create a real-life scenario of pressure ulcers.
    The figure show’s nurses knowledge and practice concerning how to prevent pressure ulcers at Gondar University Hospital, Northwest Ethiopia (Nuru et al., 2015).

    Ways of reducing knowledge and experience gap in Pressure Ulcer among Nurses.
    Boosting nursing in-service training anchored on pressure ulcers.
    Providing requisite facilities and equipment to effectively prevent and manage pressure ulcers among patients.
    Upgrading nursing courses.
    9

    Proposal to address the problem
    As pressure ulcer continues to become a major health concern globally, there is need to develop requisite prevention and management plans aimed at enhancing patient care.
    It is vital to appreciate the fact that despite massive efforts towards managing and preventing pressure ulcers, the complexity of the problem continues to increase.
    For this reason, there is need to develop an effective and efficient strategies of addressing the problem of pressure ulcers.

    Addressing the problem of pressure ulcer is becoming complex.
    As a result, clinicians, nurses and patients experience significant challenges in quest to achieving high-quality healthcare.
    Factors that have made addressing the issue of pressure ulcers difficult.
    Difficulties in categorizing pressure ulcers into levels.
    Poor inter-agency working and relations.
    Poor morale of nurses.
    10

    Addressing the problem of pressure ulcers
    First, there is need for increased inter-agency working between nurses and other medical professionals such as surgeons, clinicians, and pharmacists,
    Inter-agency collaboration will lead to formation of teams that will tackle pressure ulcers in hospitals and achieve desirable patient outcomes in the long run.
    It also closes communication gaps and this will enable nurses and other professions in health care share ideas concerning treatment of patients with pressure ulcers.

    Inter-agency working in healthcare has been given a wide berth.
    Nurses ought to incorporate it in their practice to boost knowledge and experience.
    Eventually, they will deliver high-quality care to patients with pressure ulcers.
    11

    Addressing the problem of pressure ulcers
    Nurses have a vital role to play in increasing awareness among patients at a hospital concerning risk of pressure ulcers.
    For example, nurses can advise patients at a hospital to minimize time that thy apply pressure on their skin.
    Consequently, this will help in improving skin quality thus improved health of the patient in the long run.
    It is important that nurses maximize on using pressure injury monitoring devices.
    It will help in assessing various aspects of skin such as moisture, body motion.

    Pressure-sensing mats can be placed on patients wheel-chair to monitor pressure applied thus preventing potential of sores.
    12

    Addressing the problem of pressure ulcers
    Nurses can play an integral part in developing a plan to help the caregiver of a patient follow when taking care of the patient at hospital.
    The care plan can also integrate various aspects such as position changes, good diet and lifestyle changes.
    Undertaking routine nursing assessment of patients at hospital can help identify the problem in good time.
    Early detection of pressure ulcers can help mitigate its effects on a patient in the long run.

    Factors that lead to improved health of pressure ulcer patients.
    Position changes,
    Good diet
    Lifestyle changes
    13

    Addressing the problem of pressure ulcers
    Apart from management and prevention as ways of addressing pressure ulcers, nurses can incorporate treatment as a way of enhancing high-quality patient care.
    Through surgery, a patient with pressure ulcer can be treated.
    Surgery helps to seal the wound and bring about healing.
    Surgery also reduces the risk of infection among patients in hospitals as wounds would be completely sealed.

    The biggest impediment to surgery as a way of treating pressure ulcers is that it does not suit people who are already in poor state of health.
    14

    Addressing the problem of pressure ulcers
    When addressing the issue of pressure ulcers, it is essential to consider different groups of people who are at high-risk of getting pressure ulcers.
    Adult people who are older than 70 years old have high probability of being infected with pressure ulcers due to mobility problems associated with this age.
    People with obesity also have high likelihood of getting pressure ulcer.
    Individuals who practice a poor diet also have high probability of getting pressure ulcers.

    Nurses ought to consider various aspects when handling patients with pressure ulcers.
    Central to improved patient care is accelerating awareness and education on this health problem.
    15

    Identification and Discussion of Ethical, legal and Regulatory Concerns relating to Pressure Ulcers
    Concerning ethical concerns, nurses who undertake research in pressure ulcers have to deal with confidentiality, ethical dilemmas attributed to conflict between transparency and responsibility to the patients and the requirements for research and informed consent.
    Additionally, five ethical theories that is utilitarianism, virtue ethics, deontology, egoism and care ethics form the basis of ethical aspects of nursing.
    For example, under egoism as an ethical aspect, a nurse is required not to overwork but at the same time promote self-care among patients.

    Understanding ethical aspects impacting pressure ulcers is complex.
    Five theories provide anchorage to the ethical aspects of pressure ulcers.
    Utilitarianism
    Virtue ethics
    Deontology
    Egoism
    Care ethics
    16

    Ethical Issues
    Ethical aspects of deontology and utilitarianism provide a framework where the pressure ulcer patient can access all relevant information to help in achieving best health outcomes in the long run.
    A nurse ought to inform a patient with pressure ulcers of their condition and its implications.
    Care ethics provides for delivery of patient-focused and focused treatment plans of patients with pressure ulcers.

    Nurses need to consider ethical aspects aimed at providing high-quality care to patients with pressure ulcer.
    Doing so will enable them avoid doing the wrong thing thus enhancing their professionalism.
    Training and coaching on ethical aspects can be crucial to providing patient-focused care to patients with pressure ulcers.
    17

    The Legal and Regulatory Aspect of Pressure Ulcers
    Today, lawsuits associated with patients with pressure ulcers are common and continue to increase globally.
    Under the legal aspect, assuming a patient develops pressure ulcer and that there is documentation where a doctor had been notified, in this case there will be no treatment since the physician would not have intervened (Fife, 2020).
    Consequently, this can lead to serious health problems for patients with pressure ulcers.
    It can then be classified as breach of duty and low-quality care therefore, negligence (Lockhart & Goudberg, 2002).
    An nurse or any healthcare professional can be sued.
    A nurse ought to avoid litigation by providing high standard of care to the patient with pressure ulcers.

    Legal aspects surrounding pressure ulcers vary from country to country.
    Individual countries design laws in way that suits them.
    However, one thing that cuts across regarding legal aspect is that in leverages on making health care professionals deliver high-quality care.
    18

    Explanation of why I chose the problem
    First, pressure ulcers is increasingly becoming a major health concern globally thus the reason why I chose it.
    The problem was interesting to me as there exist few studies that have be done on it.
    Additionally, the impact of pressure ulcers tend to be underestimated by many people yet they seriously impact a patient’s health.
    I wanted to explore this problem to determine how it has impacted nursing as a career based on knowledge and experience.

    Pressure ulcers is underestimated.
    It can be deadly if not detected early.
    There exist mechanisms through which nurses can improve care of patients with pressure ulcers.
    Little research has been done anchored on pressure ulcers.
    19

    Why I chose the topic
    Many hospitals especially those in developing nations have nurses who have little knowledge and experience concerning pressure ulcers
    This was an insightful finding for me.
    Pressure ulcers is a complex condition based on prevention and management thus many people shy away from examining it.
    I wanted to explore a problem that has not received the required attention
    Pressure ulcers hugely impacts the global health system yet many people ignore it.;

    Pressure ulcers as a problem has been neglected.
    Need for increased on research anchored on pressure ulcers.
    Inter-agency collaboration needed to boost quality of care given to patients with pressure ulcers.
    20

    Conclusion
    Lastly, pressure ulcers continues to evolves based on prevention, treatment and management among patients.
    Nurses need to be considerate of the ethical, and legal aspects surrounding pressure ulcers to help their patients achieve high quality care.
    There is need for increased funding on research anchored on pressure ulcers to aid in developing robust and efficient interventions that will boost patient’s health in the long.
    Eventually, nurses will be motivated and inspired to provide high-quality care.

    Future studies need to focus on how nurses knowledge and experience on pressure ulcers can be improved to achieved a patient-centered care in the long run.
    21

    References
    Berlowitz. (2022). Preventing pressure ulcers in hospitals. Agency for Healthcare Research and Quality. https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/index.html
    Fife. (2020). A Closer Look at the Legal Implications of Pressure Injuries. Todays World Clinic. https://www.hmpgloballearningnetwork.com/site/twc/articles/closer-look-legal-implications-pressure-injuries
    Lockhart, D. G. (2002). The legal implications of pressure ulcers in acute care. Critical Care Nursing Quarterly, 25(1), 63-68. https://doi.org/10.1097/00002727-200205000-00007
    Nuru, Zewdu, Amsalu, & Mehretie. (2015, May 16). Knowledge and practice of nurses towards prevention of pressure ulcer and associated factors in Gondar University hospital, northwest Ethiopia. BioMed Central. https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-015-0076-8
    Surg. (2015, January). Pressure ulcers: Current understanding and newer modalities of treatment. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4413488/

    1

    2

    Project, Translation & Planning

    Vannelyn Oriel

    University of Phoenix

    Senior Leadership Practicum

    Professor Karissa Stewart

    August 1, 2022

    In this scenario, the proposed solution to pressure ulcers is enhancing interagency collaboration in healthcare. For this reason, the exist guidelines that can provide for effective implementation of the proposed solution. First, provision of financial resources is important as it will aid in filling service gaps present in healthcare therefore, effectively dealing with the pressure ulcers. Integrating and utilizing interagency agendas anchored on healthcare and more so pressure ulcers can lead to development of a holistic healthcare management and treatment plan for patient with pressure ulcers in hospitals. Developing funding strategies to facilitate interagency collaboration will be important (Jeyaraman et al., 2017). It will ensure that adequate funds are accessed and that they are utilized in a transparent way.

    Developing agency budget collaborations will be important is it help in reducing the financial burden of a single group of healthcare professionals that are dealing with patients with pressure ulcers. Overall, the healthcare system will effectively deal with pressure ulcers. Developing communication plans and program development strategies can help improve inter-agency collaboration among healthcare professionals this providing the best care for patients with pressure ulcers (Morgan et al., 2019). All these will constitute the best practices aimed at effectively addressing the issue of pressure ulcers. 

    My proposed intervention to solving the problem of pressure ulcers is enhancing interagency collaboration among healthcare workers. Inter-agency collaboration will lead to formation of teams that will tackle pressure ulcers in hospitals and achieve desirable patient outcomes in the long run. It also closes communication gaps and this will enable nurses and other professions in health care share ideas concerning treatment of patients with pressure ulcers. Nurses can play an integral part in developing a plan to help the caregiver of a patient follow when taking care of the patient at hospital.

    The care plan can also integrate various aspects such as position changes, good diet and lifestyle changes. Undertaking routine nursing assessment of patients at hospital can help identify the problem in good time. Early detection of pressure ulcers can help mitigate its effects on a patient in the long run. Increasing awareness among patients at a hospital concerning risk of pressure ulcers (Schoeps et al., 2017). For example, nurses can advise patients at a hospital to minimize time that thy apply pressure on their skin. Consequently, this will help in improving skin quality thus improved health of the patient in the long run. It is important that nurses maximize on using pressure injury monitoring devices. It will help in assessing various aspects of skin such as moisture, body motion. 

    References

    Jeyaraman, M. M., Qadar, S. M. Z., Wierzbowski, A., Farshidfar, F., Lys, J., Dickson, G., … & Abou-Setta, A. M. (2017). Return on investment in healthcare leadership development programs. Leadership in Health Services.

    Morgan, S., Pullon, S., Garrett, S., & McKinlay, E. (2019). Interagency collaborative care for young people with complex needs: Front‐line staff perspectives. Health & social care in the community, 27(4), 1019-1030.

    Schoeps, L. N., Tallberg, A. B., & Gunningberg, L. (2017). Patients’ knowledge of and participation in preventing pressure ulcers–an intervention study. International Wound Journal, 14(2), 344-348.

    Nursing – The Problem of Pressure Ulcers and Solutions

    By: Vannelyn Oriel

    1

    Solution to Pressure Ulcers

    Resolving the problem of pressure ulcers can be complex for nurses and patients.

    One of the most effective way of resolving the problem of pressure ulcers is integrating a wider interprofessional team (IPT) technique.

    IPT technique would provide a platform where nurses, dermatologists, clinicians among other healthcare professionals can

    Interprofessional team (ITP) technique is one of the most effective and efficient solutions to pressure ulcers.
    However, ITP technique has been ignored for many years.
    Evidence-based research based on ITP technique need to be accelerated
    2

    Intended outcome of ITP technique
    The interprofessional approach aimed at resolving pressure ulcers would be effective in improving current practice or knowledge and attitudes towards diagnosing, treating, managing and preventing pressure ulcers.
    In most cases, ,many healthcare professionals have unsatisfactory levels of knowledge and attitudes regarding how to prevent pressure ulcers.
    For many years, pressure ulcers have been regarded as nursing issues which should not be the case.
    Pressure ulcers should be viewed from an interprofessional point of view and not via nursing alone.

    ITP outcomes
    Preventing pressure ulcers
    Treating and managing pressure ulcers.
    Improved morale and productivity of healthcare professionals.
    Improved efficiency of the overall healthcare system.
    3

    Description of Implementation Plan
    Nurses should have to start by embracing the identity and input of other healthcare professionals such as dermatologists, pharmacists, and clinician diagnosing, treating, managing and preventing pressure ulcers.
    Secondly, under the interprofessional (ITP) technique, all the healthcare professionals would have to share their assessments regarding patients with pressure ulcers.
    Consequently, this will aid in identifying common goals for preventing pressure ulcers.

    Implementation Plan
    Embracing identity.
    Sharing of patient assessments concerning patients with pressure ulcers.
    Developing common goals for preventing pressure ulcers.
    4

    Responsibility and Outcomes
    In this scenario, pharmacists will be responsible for providing patient-self management strategies for pressure ulcers.
    Pharmacists will provide personalized medicine for patients with pressure ulcers.
    Education and drug information relation to treating pressure ulcers will be done by pharmacists.
    All these will combine to help patient with pressure ulcers achieve desirable health outcomes in the long run.
    Generally, nurses, pharmacists, dermatologists and clinicians among other health professionals can together develop a collaborative medication therapy management for patients with pressure ulcers.
    It will help improve their knowledge and attitudes towards achieving desirable patient outcomes.

    ITP technique leads to;
    Personalized treatment for patients with pressure ulcers.
    Improved knowledge and skills regarding diagnosis, treatment, prevention and management of pressure ulcers.
    Overall, a collaborative medication therapy management system will be developed to help patients with pressure ulcers.
    5

    Time Frame
    2023
    Time Frame for Implementation of ITP approach Tasks
    Jul-18-2023 Holding an inter-professional meeting and informing all health professionals of the intended ITP approach and providing an overview of its outcomes based on pressure ulcers
    Aug-18-2023 Providing training through workshops on how various healthcare professionals can collaborate in diagnosing, treating, managing and preventing pressure ulcers.
    Nov-18-2023 Implementing a pilot program on the ITP model.
    Dec-18-2023 Assessment of the project outcomes and determining way forward.

    Importance of time frame
    Helps healthcare professionals effectively organize the work that needs to be done.
    Aids in analyzing pattern of the ITP technique to establish its viability.
    Establishing the ITP technique milestones in treating and preventing pressure ulcers.
    6

    Potential Setbacks
    Inadequate financial resources to hold training workshops to familiarize healthcare professionals on the interprofessional approach.
    Time constraints.
    Lack of communication among different healthcare professionals.
    Lack of clear goals and success assessment criteria.
    Overambitious plan

    There will always be challenges when implementing the ITP plan
    Limited time
    Financial challenges
    Being too overambitious with the plan
    Poor communication.
    7

    Risk Management Plan
    The biggest risk for implementation of this ITP approach project is the lack of clarity since nurses, clinicians and dermatologists might not effectively understand their roles in preventing and managing pressure ulcers.
    Secondly, it would be important to undertake qualitative analysis of the risks
    Monitor the identified risks to ensure that their effects are mitigated.

    Risk Management Plan aids in:
    Knowledge of a contingency budget
    Maximizing on benefits
    Minimizing on costs
    Increasing awareness regarding the project’s progress
    8

    Tasks needed before taking any action
    Communicating to the various healthcare professionals to enhance clarity regarding implementation of the ITP approach in preventing pressure ulcers among patients in hospitals.
    Ensuring availability of resources such as finances.
    Undertaking preliminary assessment of the project before implementation would be effective in identifying gaps and solving them.
    Availability of enough healthcare professionals.

    Pre-task analysis serves to:
    Make healthcare professional be aware of the ITP technique to be implemented.
    Reduce potential errors that might accrue in the project.
    Increases quality of healthcare provided to patients.

    9

    Budget Role
    Project Activity Expected Budget Actual Budget
    1. Planning for implementation of the ITP approach among healthcare professionals $10,000 _
    2. Executing the ITP approach by for example facilitating training of healthcare professionals on how to achieve interprofessional collaboration in healthcare environment. $40,000 _
    3. Controlling the implementation of the ITP approach $5000 _
    4. Closing the project $0 $0
    Total project cost $55,000 _

    The actual budget is zero since the ITP technique as a project has not been completed.
    The total expected cost for implementing the ITP technique in a healthcare environment aimed at enhancing health of patients with pressure ulcers is $55,000.
    However, the actual budget is unknown as it can be higher or lower than the expected budget.
    10

    EBP Model
    Based on EBP model, evidence show that there is limited interprofessional collaboration in treating and preventing pressure ulcers.
    For example, the problem of pressure ulcers has always been a nursing issue only which should not be the case.
    Additionally, many clinicians have limited knowledge and skills regarding pressure ulcers
    EBP model would also take into account the patient’s wants and needs.

    Findings from EBP Model
    Limited interprofessional collaboration among health professionals.
    Clinicians have limited knowledge and skills regarding pressure ulcers.
    EBP model integrates the needs and wants of patients with pressure ulcer thus helping them achieve desirable health outcomes in the long run.
    11

    Description of evaluation plan
    In this case, the short-term outcome will be to explore and determine the knowledge and attitudes of healthcare professionals based on the interprofessional approach.
    Questionnaires would be disseminated to the healthcare professionals via online.
    The data will be analyzed using descriptive and inferential statistics.

    Data collection
    Use of questionnaires.
    Descriptive and inferential statistics can be used to analyze the data.
    12

    Description and evaluation plan
    The long term outcome will be achieving desirable health outcomes among patients.
    Pressure ulcers prevention presents a unique clinical challenge to every healthcare professional thus the need for interprofessional approach.
    ITP integrates knowledge and experience from across the healthcare team thus effective prevention of pressure ulcers (Clarkson et al., 2019).

    Interprofessional team approach is vital in combining knowledge, and skills of different healthcare professionals in achieving desirable health outcomes among patients with pressure ulcers.
    13

    References
    Clarkson, P., Worsley, P. R., Schoonhoven, L., & Bader, D. L. (2019).

    An interprofessional approach to pressure ulcer prevention: A knowledge and attitudes evaluation

    . Journal of Multidisciplinary Healthcare, 12, 377-386. https://doi.org/10.2147/jmdh.s195366

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