Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages To Order 5-10 Pages Description/Paper Instructions
Introduction presented in opening paragraph(s) identify problem, why was it chosen?, How will it be improved? Use PICO to help guide construction of problem statement.
The purpose of this study is to review data related to pressure ulcer among clients who are confine in bed due to several reasons. This condition is more common among clients who received mechanical ventilation and bed ridden cause by ineffective turning and reposition. From this review bedsides nurses and nursing assistant will have a better understanding of the benefits of turning and repositioning those clients and the risks of not doing it properly and why new evidence must be developed for optimal care for those clients who are unable to reposition themselves. Since the tissue of the body are not meant to be stationary and the average healthy person supposed to repositions him or herself every 6 to 11 minutes (Keane Fx, 2013).
Pressure ulcers is a huge problem confronted all over the health care institutions in the United States. Bed sores affects approximately 1.3 to 3 million clients in the USA (Chou, 2013). The annual cost of pressure ulcers is approximately 11 billion dollars, with the treatment range per pressure ulcers at 37,800 to 70,000 in the United States(Smith,2013). Almost 60% of stage 3, 4 and unstageable bed sores acquirer in the hospitals are develop on the sacral, coccygeal, buttocks region 30% are from medical devices and 10% from other. Since October 2008, hospitals no longer receive Medicare reimbursement for clients who acquire stage 3 or 4 pressure ulcers during their inpatient stay (Zaratkiewica et al., 2010). Private insurance is also adopting these reimbursement restrictions (Mattie& Webster, 2009). This PICO review’s questions will focus more among clients on vents and bed bound, how turning and repositioning every 15 minutes or less Since the tissue of the body are not meant to be stationary and the average healthy person supposed to repositions him or herself every 6 to 11 minutes (Keane Fx, 2013). For this review we will use two method the tracker device and the manual turning who is traditional intervals of every two hours around the clock. With the specialized team the manual turning should be sooner than every 2 hours. The specialized team of nursing assistant only assigned to those patients with a tracker device attach to the nursing assistant letting the nurse on charge of that team know if they did turn and reposition the client assign on the time frame given. For example, the team took twenty minutes to change and repositioning the client will be rate has excellent, more than twenty minutes with changing or only repositioning will be marked as need improvement, more than fifteen minutes with turning and repositioning will be equal to very poor etc….
The intention of this review is to assess which methods best prevents pressure ulcers in vents and bedbound clients compare to before and after interventions?P = PROBLEM
PRESSURE ULCERS ON VENTILATOR AND BEDBOUND PATIENTS.
I= INTERVENTION
IMPROVE AND REDUCE PRESSURE ULCERS ON VENTILATOR AND BED BOUND PATIENT BY FORMING A SPECIALIZED TEAM TO CLEAN AND REPOSITION THOSE SPECIFIC PATIENT, UTILIZE A GPS DEVICE TO KEEP TRACK ON PATIENTS TURN AND REPOSITION
C= COMPARAISON
USE DATA BASE TO CCOMPARE BEFORE AND AFTER INTERVENTION IMPLEMENTATION.
O= OUTCOME
ATTAINING A REDUCED NUMBER OF PRESSURE ULCERS OF 65% FROM PREVIOUS DATA AND AN AMELIORATION OR HEALING OF BED SORES FROM STAGE 4 TO STAGE 2 OR HEAL AT THE END OF THE TRIAL (3 MONTHS)
Bedsores also call pressure ulcers are cause by too much pressure on the skin. This condition is more common in vents and bedridden clients. These pressure ulcers not only cause pain and discomfort, but most of the time they lead to severe infection like cellulitis, meningitis, endocarditis according to Health link BC. The most sites that are mostly affected are elbows, heels, hips, shoulders blades because these are areas that contains little muscle and fat so for this matter frequency of manual turning and positions by a specialized team in fifteen minutes’ time frame among clients on vents and bed bound will be an immense help.
Even do manual turning is every two hours at the traditional intervals unfortunately 90% of clients who needs assistance in repositioning do not received it every two hours despite these guidelines (AACN,2017). Frequent turning, repositioning and maintain sick clean is vital to prevent pressures ulcers, improve oxygenation, alter comfort, decrease urinary stasis and provide therapeutic sensory stimulation. This why clients in mechanical vents and bedridden must be reposition and turning the positioned more frequently than every 2 hours since this will be there only assignment. The nurse on charge of the team will teach the repositioning and turning techniques and the benefit of manual turning the client.
Position for client who are on mechanical ventilation most of time they are on activity restriction. So, the specialized team who will repositioning those clients will use the lateral tilt meaning side-lying position of 30 degrees to 60 degrees shoulder and hip tilt from supine position. The skin should be kept clean and dry, use pillows between parts of the body that press against each other for example to specialized team that reposition and turning will put the pillow between the knees and ankles and help the patients by doing passive range of motion exercise will be and immense help to prevent pressure ulcers . teaching the team how to prevent friction and shear and inspect the skin when turning and repositioning the clients.
The benefits of frequent physically turning improved regional ventilation in the lung areas and alternating gravitational forces for drainage of mucus from sinus and lung cavities. Decrease discomfort from immobility particularly back pain. Prevent urine stasis associated with urinary tract infection. Finally, it provides human contact and stimulation that may reduce delirium.
Stakeholders: State whether problem is linked to a national quality or safety indicator (JCAHO, NDNQI, Healthy People, etc.) If yes, indicate which indicator, and how problem is similar or linked to the indicator.
LITERATURE REVIEW PART
Background Information: Summarize evidence based articles from the review of literature on the problem. Clearly state how your group used the information to identify the problem and potential solutions/interventions.
Search strategy
The search for articles was conducted through PubMed,
The search included the terms pressure ulcers, pressure ulcer prevention, turning and repositioning
DEVELOPMENT
Narrative Summary of approach to solving the problem, including recommended interventions. Describes implementation challenges further substantiated by the literature. Includes examples pertinent to work experience
GPS DEVICE USE AND COST
MANAGEMENT CONTACT FOR APROVAL
COST FOR PATIENT DEVELOPING BED SORES DISBURSED BY THE HOSPITAL FOR A CERTAIN AMOUNT OF PATIENT
IS DEVIVE COST EFFECTIVE
HOW MANY PATIENTS WILL BE INVOLVING IN THE TRIAL
STAFF DISTRIBUTION PER SHIFT 12 HOURS (CNA)
WHAT WILL BE DONE TO ENCOURAGE COMPLIANCE
Conclusions drawn from state of current evidence in the nursing literature regarding the performance improvement plan.References for The Effectiveness of a Pressure Ulcer Intervention Program on the Prevalence of Hospital Acquired Pressure Ulcers: Controlled Before and After Study.
Mallah, Z., Nassar, N., & Kurdahi Badr, L. (2015). The Effectiveness of a Pressure Ulcer Intervention Program on the Prevalence of Hospital Acquired Pressure Ulcers: Controlled Before and After Study. Applied Nursing Research, 28(2), 106-113. doi:10.1016/j.apnr.2014.07.001
References for The Turn Team: A Novel Strategy for Reducing Pressure Ulcers in the Surgical Intensive Care Unit
D Still, Mary & C Cross, Linda & Dunlap, Martha & Rencher, Rugenia & R Larkins, Elizabeth & Carpenter, David & Buchman, Timothy & Coopersmith, Craig. (2013). The Turn Team: A Novel Strategy for Reducing Pressure Ulcers in the Surgical Intensive Care Unit. Journal of the American College of Surgeons. 216. . 10.1016/j.jamcollsurg.2012.12.001.Pressure ulcer risk assessment and prevention: A systemic comparative effectiveness review. Annals of Internal Medicine, 159 (1), 28-38.doi:10.7326/0003-4819-159-1-201307020-00006
Zaratkiewica, S., Whitney, J., Lowe, J., Taylor, S., O’Donnell, F., & Minton-Foltz, P. (2010).
Development and implementation of a hospital-acquired pressure ulcer incidence tracking system and algorithm. Journal for Healthcare Quality, 32(6), 44-51.
doi:10.1111/j.1945-1474.2010.00076.x
Keane FX. The minimum physiological movement required for a man supported on a soft surface. Paraplegia. 16, 389-9. 2013
. http://ccn.aacnjournals.org/byAACN on october 16,2017
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. The can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
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