Rehabilitation for Post-Surgical and Stroke Patients

Posted: November 8th, 2022

Rehabilitation for Post-Surgical and Stroke Patients

Benchmark: Capstone Project Change Proposal

            Pressure ulcers are among health issues raising concerns among healthcare practitioners. It is a localized injury that occurs to the skin due to pressure. This condition can either affect the skin or the underlying body tissue. Its risk can be increased by intrinsic or extrinsic factors. Patients diagnosed with pressure experience considerable suffering due to pain (Sari et al., 2019). Thus, it has an impact on various aspects of the patient’s quality of life, including physical, emotional, and social. Additionally, this condition might result in death if it is not treated on time (Jaul & Calderon-Margalit, 2015). On the other hand, pressure ulcers expose healthcare facilities to an economic burden. While the concept of pressure ulcers is broad, this paper will focus on the background, problem statement, the aim of the change proposal, the PICOT, strategies employed in literature search, the evaluation of the literature, applicable change, and the implementation of the proposed plan and the outcome measures.Rehabilitation for Post-Surgical and Stroke Patients

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Background

The prevalence of pressure ulcers has been rising drastically globally. Particularly, the incidence of this condition is higher among people above 70 years. Additionally, in patients diagnosed with other chronic conditions are prone to this condition (Jaul et al., 2018). Nonetheless, the development of pressure ulcers is common prior to hospitalization. According to Corbett et al (2017), the rate of community-acquired pressure ulcers is relatively high. Between 3.3% and 11.1% of cases are reported during hospital admission (Corbett et al., 2017). Besides, older adults aged 70 years and above reported around 70.6% of cases of pressure ulcers before hospital admission (Corbett et al., 2017). Only about 21.4% of this patient population had received care services at home before being admitted (Hahnel et al., 2017). The significant increase in the prevalence of this condition necessitates the implementation of some intervention measures. The prevalence of pressure ulcers will be reduced through an increase in staff education and implementation.Rehabilitation for Post-Surgical and Stroke Patients

Problem Statement

Too many cases of pressure ulcer development have been reported. According to Sari et al (2019), the rate of pressure ulcers among inpatients in the US raised from 3.1% to 30.0% in 2019. Europe also experienced a significant increase in the cases of pressure ulcers from 1% to 54%. Australia registered a 6% increase in the rate of pressure ulcers. Furthermore, an increase from 2.7% to 16.8% was registered in Asia (Sari et al., 2019). The high incidence of pressure ulcers is attributed to a significant decrease in staff education and implementation. Consequently, healthcare practitioners lack vital skills, which are required in handling patients with pressure ulcers in healthcare facilities.

Purpose of the Change Proposal

This change proposal aims at reducing the high prevalence of pressure ulcers by finding new ways to increase staff education and implementation. This intervention measure will, in turn, decrease the development of pressure ulcers and facilitate the wound healing process.

PICOT

            The PICOT question in this cases is, “Among hospitalized middle to late adulthood stroke and post-surgical inpatients in the Inpatient Rehabilitation Center, (P), can a multifaceted evidence-based educational intervention (I) that is linked to the treatment and prevention of pressure ulcers in comparison to the absence of formal education (C) result in enhancing the confidence and knowledge of nurses in caring for patients that have pressure ulcers or are at risk of acquiring PU within 3 months.”

The Implemented Literature Search Strategy

This project was based on the work of other scholars who had conducted studies on the high prevalence of pressure ulcers among stroke and post-surgical inpatients. A literature search strategy was used to obtain the required information from nursing and health-related database. The selected literature search strategy combined major concepts of the PICOT question to retrieve the required data successfully. The first step involved writing down the proposed research question appropriate. Writing the question enabled the researcher to define what to search from the existing literature. The second step involved preparing a list of keywords, phrases, and terms to be used during the search. These keywords are vital since they acted as guides to the researcher, thus preventing the search of irrelevant information from the selected database. Additionally, the researcher prepared a list of synonyms of the keywords. Thirdly, subject headings were also used to search for the required data. Finally, the researcher identified the most appropriate nursing and health-related databases. These databases would be used to source for the required information.Rehabilitation for Post-Surgical and Stroke Patients

Evaluation of the Literature

            The obtained literature was evaluated to check its relevancy of the gathered data to the proposed project. The assessment was based on the effectiveness of the collected information in addressing the proposed research question. Additionally, the evaluation involved the analysis of the strengths and weaknesses of the collected data. Any contradictions and gaps were also identified. Thus, evaluation enabled the researcher to determine whether the gathered data was appropriate for the study or not. In case, the data was inadequate, more resources would be reviewed to get the appropriate information.

The Applicable Change

The high prevalence of pressure ulcers among different patient populations necessitates change. The proposed change aims at increasing the level of staff education and implementation. In particular, the use of a multifaceted evidence-based education intervention will enhance the level of knowledge and confidence among the nurses working in a rural setting (Van et al., 2017). Doing so will enable these nurses to take care of patients with pressure ulcers or who are at a high risk of acquiring pressure ulcers (Hommel et al., 2017). This action will, in turn, facilitate the wound healing process, thus reducing the high incidence of pressure ulcers (Porter‐Armstrong et al., 2018). Therefore, the implementation of a multifaceted evidence-based education intervention would be more effective in lowering the high level of pressure ulcer cases compared to the absence of formal education. In the latter approach, nurses seek to treat pressure ulcers patients without nursing knowledge related to the effective management of the condition.Rehabilitation for Post-Surgical and Stroke Patients

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The Implementation of the Proposed Plan and outcome Measures

The proposed plan involves the use of a multifaceted evidence-based education intervention to enhance the level of knowledge and confidence among the nurses. Nurses will use the acquired knowledge and skills to take care of patients diagnosed with pressure ulcers. The effectiveness of a multifaceted evidence-based education plan in addressing the issue of the high incidence of pressure ulcers will be reflected through various outcome measures.

First, a decline in the cases of pressure ulcers in the healthcare facilities will reflect the success of the implemented plan. The nurses will use the acquired knowledge to take care of ulcer patients, thus reducing the high incidence of the condition. Additionally, a significant decline in the number of death cases attributed to pressure ulcers indicates the success of the adopted plan. The implementation of the acquired knowledge in delivering patient-centered care will facilitate recovery, which will, in turn, reduce the number of reported death cases. Finally, the success of the plan will be reflected by a decline in the number of readmission cases among pressure ulcer patients. The delivery of quality care will facilitate the healing and recovery of the patients suffering from the condition.

Potential Barriers to the Implementation of the Plan

The implementation of the plan in the healthcare facilities will be hindered by various factors. The first limitation involves the reluctance of the nurse to embrace the change. In most cases, practitioners are unwilling to support new interventions since it would require them to acquire more knowledge and new skills. This challenge can be overcome by informing the nurses of the benefits of implementing the plan in the healthcare organization. One should emphasize that applying evidence-based knowledge in taking care of patients will enhance the quality of care and patient outcomes. Additionally, the lack of the required funds to cater to training expenses will limit the implementation of the plan. This challenge can be addressed by sourcing for funds from potential donors and other stakeholders in the healthcare sector.Rehabilitation for Post-Surgical and Stroke Patients

Conclusion

The implementation of evidence-based knowledge will enhance the delivery of quality care among pressure patients. Thus, this intervention will minimize the high prevalence of pressure ulcers. The effectiveness of this intervention will be reflected by various outcome measures, including a decline in death cases related to the condition and reduction in readmission. However, the effectiveness of the plan will be limited by the reluctance of the nurses to support the plan and lack of the required funds to support the training program.

References

Corbett, L, Q., Funk, M., Fortunato, G., & O’Sullivan, D, M. (2017). Pressure injury in a Community Population: A Descriptive Study. J Wound Ostomy Continence Nurs, 44(3):221-227.

Hahnel, E., Lichterfeld, A., Blume-Peytavi, U, & Kottner J. (2017). The epidemiology of skin conditions in the aged: A systematic review. J Tissue Viability; 26(1):20-28.11.

Hommel, A., Gunningberg, L., Idvall, E., & Bååth, C. (2017). Successful factors to prevent pressure ulcers–an interview study. Journal of Clinical nursing, 26(1-2), 182-189.

Jaul, E & Calderon-Margalit, R. (2015). Systemic factors and mortality in elderlypatients with pressure ulcers. International Wound Journal, 12(3):254-259.

Jaul, E., Barron, J., Rosenzweig, J. P., & Menczel, J. (2018). An overview of co-morbidities and the development of pressure ulcers among older adults. BMC geriatrics, 18(1), 1-11.

Porter‐Armstrong, A. P., Moore, Z. E., Bradbury, I., & McDonough, S. (2018). Education of healthcare professionals for preventing pressure ulcers. Cochrane Database of Systematic Reviews, (5).

Sari, S, P. et al. (2019). The prevalence of pressure ulcers in community-dwelling older adults: A study in an Indonesian city. International Wound Journal, 16(1): 1-8.

Van, L., Schols, A., Hovius, R, Halfens, G. A. (2017). Secondary Analysis of Longitudinal Prevalence Data to determine the use of Pressureulcer Preventive Measures in Dutch Nursing Homes, 2005-2014. OstomyWound Manage; 63 (09):10-20.

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Rehabilitation for Post-Surgical and Stroke Patients