The final capstone project is a series of written research-based assignments completed throughout this course
Problem, Purpose, and Questions: Evidence-Based Practice Proposal
The final capstone project is a series of written research-based assignments completed throughout this course that culminate in a final evidenced-based proposal paper and presentation. Students are encouraged to share their completed proposals with a healthcare organization that could benefit from the proposal. For this first assignment, you will select the topic for your evidence-based intervention project.
Investigate a healthcare issue or problem in your area of disciple that can be improved by implementing an evidence-based intervention. The resolution of this problem or issue should support or improve patient care. Use the PICO format to develop a PICO question (clinical question) for your proposed evidence-based intervention project. Refer to the “PICO Guide” to help guide you through this process.
In a formal paper of 500-750 words, address the following:
- Describe the health care issue or problem you selected. Explain why it is a problem in your discipline.
- Describe the target population for your intervention and explain how the population is affected by this issue or problem.
- Based on the results of your PICO formatting, draft one or two questions for your proposed topic. These questions will be the basis for your implementation plan.
You are required to cite to a minimum of three peer-reviewed or scholarly sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and health care setting.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite webpage for guidance regarding assignments requiring submission to LopesWrite.
Expert Answer and Explanation
Evidence-Based Practice Proposal
Problem
The issue of concern selected for the research is the pressure ulcer among patients in long-term care facilities. Within these facilities, patients sit or lie on bed for long hours or for days, resulting to the exertion of pressure on their skin tissues. This sustained pressure causes injuries or sores particularly in the sacrum, ischium and other body parts with bones. The condition primarily results because of the blockage of the blood flow to tissues due to the effect of the pressure on the skin.
This denies tissues the nutrients they need to be in good health. The rubbing of the skin against the beddings is the other cause of the bedsore (Gillespie et al., 2020). However, certain conditions tend to expose patients to the risk of developing this particular clinical issue. If a patient has a disorder that affects the flow of blood to tissues, for instance, their risk of developing pressure ulcers is significantly high. Dehydration, decline in the ability of the skin to sense pain, and immobility are the other risk factors for the clinical issue (Wilson et al., 2023).
As a clinical problem, pressure ulcer is associated with a wide range of complications that may cause the patient’s health to worsen. One of these complications is cancer considering that when pressure ulcers recur, it is likely to cause chronic inflammation, which is tied to the epidermoid carcinoma. Given the difficulty involved in managing the wound, abscess may develop in the affected areas because of the frequent infections. In certain cases, a patient may feel pain due to pus.
Osteomyelitis is also a complication, and it occurs when the infection in the ulcer wound affects the bone tissues. The wound may also provide the inlet for the bacterial infection, triggering an abnormal autoimmune response (Afzali Borojeny et al., 2020). Considering these complications, pressure ulcer is a problem my discipline because it causes prolonged hospitalization, and results to more workload for providers.
Purpose
The suggested intervention is the use of standard care protocol with patient education, and it targets patients in long-term care facilities. These patients are primarily seniors, receiving a wide range of services in long-term care facilities including nursing and adult homes. For this group, prolonged stay in bed and on wheelchairs causes them to develop pressure sores.
The delicate and thin skin that characterizes this group is the reason why the population is at risk of developing the clinical issue. The incontinence of the urine and faecal matter in this population is prevalent. The dumpiness of the skin linked to this incontinence is a risk factor for the development of the pressure sore. In addition, the elderly experience nutritional issues that make them susceptible to various forms of skin injuries.
The deterioration of individuals’ physical health as they age may adversely affect their eating habits, resulting to the nutritional issues (Norman, Haß, & Pirlich, 2021). Furthermore, seniors have weak bones, which expose them to the risk of fall. Frequent falls causes injuries that exacerbate the pressure sores. Therefore, old age poses a serious bed sore risk factor for the elderly.
Questions
Question 1
Population- Patients in long-term healthcare facilities who are likely to develop pressure ulcer.
Intervention – Standard care with patient education.
Comparison – Standard care without patient education.
Outcomes – The reduction of the number of cases of patients with pressure ulcers.
Time – A month following hospitalization.
In patients in long-term healthcare facilities who are likely to develop pressure ulcers, how does standard care that include the use of mattress and patient positioning, combined with patient education, compares with the standard care without patient education?
Question 2
Population – Patients admitted in long-term care facilities who are at risk of developing pressure ulcers.
Intervention- Comprehensive intervention that addresses various aspects of the patient needs with focus on preventing pressure sores.
Comparison – Standard intervention that focuses on the use of the required bedding and patient positioning.
Outcomes – The reduction in the number of cases of pressure sores among the targeted patient population.
In patients admitted in long-term care facilities who are at risk of developing pressure ulcers, how does comprehensive intervention that addresses various aspects of the patient needs with focus on preventing pressure sores, compares with standard intervention that focuses on the use of the required bedding and patient positioning, in causing a reduction in the number of cases of pressure sores among the targeted patient population.
References
Afzali Borojeny, L., Albatineh, A. N., Hasanpour Dehkordi, A., & Ghanei Gheshlagh, R. (2020). The Incidence of Pressure Ulcers and its Associations in Different Wards of the Hospital: A Systematic Review and Meta-Analysis. International journal of preventive medicine, 11, 171. https://doi.org/10.4103/ijpvm.IJPVM_182_19.
Gillespie, B. M., Walker, R. M., Latimer, S. L., Thalib, L., Whitty, J. A., McInnes, E., & Chaboyer, W. P. (2020). Repositioning for pressure injury prevention in adults. The Cochrane database of systematic reviews, 6(6), CD009958. https://doi.org/10.1002/14651858.CD009958.pub3.
Norman, K., Haß, U., & Pirlich, M. (2021). Malnutrition in Older Adults-Recent Advances and Remaining Challenges. Nutrients, 13(8), 2764. https://doi.org/10.3390/nu13082764.
Wilson, H., Avsar, P., Patton, D., Budri, A. M. V., & Moore, Z. (2023). Skin hydration measurement and the prediction of the early development of pressure ulcers among at risk adults: A systematic review. International wound journal, 20(3), 880–891. https://doi.org/10.1111/iwj.13934.
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