Pressure Ulcers PICOT Question
Pressure Ulcers PICOT Question
Develop a PICOT
In a document of between 700 and 1100 words (3 to 4 pages), identify an evidence-based problem from a clinical setting (such as long-term care, home care, or community agency). Develop a well-written clinical question using the PICOT, PICO, or PIO method (P = Population, I = Implementation, C= Comparison, O = Outcome, T = Time).
In your assignment, be sure to include the following:
• An introduction to the problem, including your personal connection to this problem and a brief summary of relevant background information
• Information about the population who will be affected by the resulting project
• A well-written PICOT/PICO/PIO question, including your rationale for why this is an EBP or QI question
and not a research question
• An assessment of the feasibility of, and potential barriers to, the change you’re proposing
• Identification of the stakeholders involved in the practice change or quality improvement (for example,
the agency from whom you would need permission to complete the project)
A note about the question: Learners sometimes have problems writing an EBP/QI question but write a research question instead. An EBP/QI question should never use the words how or why. Those terms belong in a research question. Your question should acknowledge that evidence already exists. Below are some examples. Instead of asking:
• How does the use of kangaroo care help increase infant weight gain? (a research question)
You will ask:
• Will nurses (P) who attend a class on the practice change of using kangaroo care (I) score higher on a
post-class test than on a pretest given before the class (O)? Pressure Ulcers PICOT Question
Instead of asking: What is the effectiveness of a pressure injury prevention bundle for adult intensive care unit (ICU) patients? (a research question)
You will ask: • In adult intensive care unit (ICU) patients (P), will the implementation of a pressure injury prevention bundle (I) compared to receiving standard pressure injury prevention (C) reduce the incidence of pressure injuries (O) after two months (T)?
Instead of asking:
• What is the relationship between self-reported job satisfaction among nurses and turnover intentions? (a research question)
You will ask:
Among nursing staff in a large urban hospital (P), will a decrease in
the patient-to-nurse ratio (I) reduce RN turnover (O) after eight
months (T)?
Pressure Ulcers PICOT Question
Pressure Ulcers
Pressure injuries, also known as pressure ulcers, are prevalent complications in long-term care facilities because patients are often bedridden and elderly. Pressure injuries have the potential to cause complications such as infections and pain, making the patient spend more days in the hospital and affecting the quality of life. This particular topic is of significance to me because I have firsthand experience working for a long-term care facility, within which I’ve witnessed the Initial onset of pressure injuries in immobile patients even while practicing preventive measures (Mazzucco et al., 2024). Research supports enhanced pressure injury preventive measures like timely turning, nutritional support, and pressure Ulcer Relief Devices, many of which decrease pressure injury occurrence. Yet, deficits in manpower and consequent non-compliance with the disease prevention standards lead to less-than-ideal patient outcomes. This issue supports the general notion that pressure injury prevention needs a more rigorous process.
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Population Affected
The targeted population that will significantly benefit from this project includes elderly patients in long-term care facilities, many of whom are most vulnerable to pressure injuries. They are often bed or chair-bound with underlying medical conditions and other related diseases liable to compromise skin integrity. Other staff include nurses and certified nurse assistant CNAs, who are also charged with implementing preventive measures within the facility (Tsai et al., 2023). The required aim and objective can be directly related to enhancing care practice and the overall health of this population, decreasing new implications, and improving quality of life.
PICOT Question
P: In elderly patients in long-term care facilities who are at risk of developing pressure injuries,
I: will the implementation of a comprehensive pressure injury prevention bundle,
C: compared to standard care practices,
O: reduce the incidence of pressure injuries,
T: over six months?
This is an evidence-based practice EBP because it asks for the identification of pressure injury prevention practices that have been evidenced to be valid and that could be used in standard practice. It should not seek new findings that would be true with a research question. Rather, it attempts to assess the applicability of effective interventions in other contexts for particular clinical problems in long-term care. So, there is a rationale for this question because it allows researchers to create easier, faster, and more effective intervention processes for patients. This PICOT question is an EBP question rather than research: It does not ask ‘How’ and ‘Why’ pressure injuries occur. Instead, it builds on trying to organize an intervention that will be proven to enhance the results of patients. Posed questions of the type ‘Will the use of a detailed pressure injury prevention bundle decrease pressure injuries’ to enhance practice regarding the issue by applying the research findings.
Viability Of The Organization Change Proposed and Possible Impediments
The possibility of implementing a pressure injury prevention bundle in a long-term care facility may vary depending on two aspects: staff availability and resources needed and staff engagement in the change process. Another may be a need for more time from the staff since most employ few nurses. Activities, such as repositioning patients, must be done with enough staff to do it continuously. Furthermore, some infrastructures will not afford enhanced pressure-relieving devices, including specially designed mattresses, which would otherwise enhance the intervention. The third hazard is associated with staff education and training, which may be considered a barrier to implementing telemedicine services (Osuagwu et al., 2023) Pressure Ulcers PICOT Question. Since the key aspects of the prevention bundle concern pressure injury prevention techniques such as skin assessment, repositioning schedules, and the use of appropriate gear, all team members need to be trained on the right techniques. Such changes need leadership support, staff training, and the `compliance check’ tool. However, there are barriers to implementing this intervention: leadership and staff. The intervention is feasible if the resources are available. For the project to work effectively, they will need training program funding, enhanced staffing, and cost-reducing gadgets. Moreover, clear communication of change and systematic control of change communication quality can establish protocols that counteract the opposition to change.
Major actors who participate in the process of practice change
Before changing the practice, the individuals outlined below must participate in it. First, the top management or care home will have to endorse the project and provide adequate funds for training the employees and purchasing the equipment. The main stakeholders are nursing staff: registered nurses (RNs) and CNAs because they will be implementing the prevention bundle and must guarantee that each component is being applied (Mazzucco et al., 2024). Co-workers on the front lines directing care must be equipped and prepared throughout the implementation process. Lastly, conversant quality improvement committees, which are found in any facility, should be involved in tracking and evaluating the impact of the intervention. Patients and their families can also be viewed as stakeholders since they will be affected by the results of the project. To promote adherence to preventive measures, families need to be informed about pressure injury prevention and included in the care process.
Conclusion
Because pressure injury prevention is a vexing problem, it is reasonable and imperative to employ a systematic approach to address it, such as creating a pressure injury prevention bundle. Hence, through understanding these best practices and, most importantly, the actual start of this project, the recognition of reduced incidences of pressure injuries has the propensity of positively ‘changing’ patient outcomes, bettering the quality of care offered. Despite barriers like a lack of human resources and other resources, the problem can be solved with good leadership, effective training, and supervision. The stakeholders in this quality improvement plan include the nursing staff, the leadership in the facility, and the patients Pressure Ulcers PICOT Question.
References
Mazzucco, L., Balbo, V., Zingarelli, E. M., Desilvestri, M., Marchioni, M., Perrero, L., … & Varvello, I. (2024). Treatment of severe pressure ulcers with protein-enriched filtered platelet-rich plasma (PEFPRP): a possible management. Frontiers in Bioengineering and Biotechnology, 11, 1279149. https://doi.org/10.3389/fbioe.2023.1279149
Osuagwu, B., McCaughey, E., & Purcell, M. (2023). A pressure monitoring approach for pressure ulcer prevention. BMC Biomedical Engineering, 5(1), 8. https://link.springer.com/article/10.1186/s42490-023-00074-6
Tsai, Y. J., Lin, C. H., Yen, Y. H., Wu, C. C., Carvajal, C., Molte, N. F., … & Hsieh, C. H. (2023). Risk factors for pressure ulcer recurrence following surgical reconstruction: A cross-sectional retrospective analysis. Frontiers in Surgery, 10, 970681. https://doi.org/10.3389/fsurg.2023.970681 Pressure Ulcers PICOT Question
