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Design for Change in Practice

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Design for Change in Practice
Dustin Ashenfelter
Chamberlain College of Nursing
Capstone in Nursing
NR 451
Professor Linda Fry
Winter 2011

Design for Change in Practice The increasing prevalence of Hospital Acquired Pressure Ulcers (HAPU) is a problem that is plaguing hospital’s across the nation. The estimated added expense in managing a single full thickness pressure ulcer can be as high as $70,000.00, and the total cost to hospitals across the nation could be as high as $11 billion/year (Lynch & Vickery, 2010). Initial identification of at risk patients has been one of the keys to successfully reducing stage 3 and 4 reported pressure ulcers. The Braden scale for predicting pressure sore risk is a universally accepted tool used to help nurses identify patients who are at risk of developing pressure ulcers. The scale evaluates each patient in the following six areas exposure to moisture, sensory perception, activity, and ability to change positions, nutrition, and exposure to shear (Rosenfeld, 2010). The identification of unit specific champions is a key strategy for the continued reduction of the prevalence of pressure ulcers. These leaders on the units serve as the educators for the remaining staff on the unit. These champions would be part of a multidisciplinary team, which reviews all new research, assistive devices, and evidence-based practice concerning the treatment and prevention of pressure ulcers. The multidisciplinary team would focus on key points the help take aggressive action against pressure ulcer prevention, some of the key points are education, documentation, setting benchmarks , and walk rounds. Education would focus on proper assessment, staging and accurate completion of the Braden scale. Consistent and thorough education would be provided to the patient and family. Documentation would be uniform and reduced to a

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