Project Title
Date of Award
Summer 2023
Document Type
Final DNP Paper
Degree Name
Doctor of Nursing Practice (DNP) in Adult-Gerontology Acute Care Nurse Practitioner
Department
Nursing
Faculty Chair
Dr. Heather Wallace DNP, AGACNP-BC, CCRN, COI
Abstract
Background: Pressure injuries in the United States affect between 1-3 million people. Of the percentage of patients affected by pressure injuries, a range from 2% to 28% of those patients are in long-term care facilities. In Alabama, the pressure injury rate in long-term care facilities ranges from 2.3% to 18.4%. According to this long-term care facility's November 2022 quality improvement report, the acquired pressure rate rose from 2.2% to 8.3% in a year. A total of nineteen newly acquired pressure injuries were reported. Eleven of the nineteen pressure injuries occurred in the long-term stay unit, accounting for almost 58% of this facility's acquired pressure injuries. In the United States, pressure ulcers cost $9.1-$11.6 billion per year of health care cost. Pressure causes pain, decreased mobility, decreased quality of life, increased chances of developing an infection, and increased risk of morbidity and mortality. This practice improvement project aimed to reduce acquired pressure injuries in a long-term care facility over eight weeks.
Purpose: This project was intended to reduce the percentage of acquired pressure injuries to less than 3% in eight weeks by implementing an evidence-based pressure injury prevention bundle. The secondary goal is to evaluate the impact of implementing an evidence-based pressure injury bundle on acquired pressure injuries in a long-term care unit in rural Alabama compared to the facility's current plan in place, which only consisted of standard orders for treating pressure injuries rather than preventive measures.
Method: This project will utilize a pretest and posttest design to compare the rate of pressure injuries acquired before and after the intervention. Additionally, it will evaluate the effectiveness of the Agency of Healthcare Research and Quality's Pressure Injury Prevention Injury Pathway for Acute Care in preventing pressure injuries, as compared to the current plan adopted by the facility, which involves treating pressure injuries through standing orders after they have occurred.
Results: Preintervention data showed that eleven of the fifty-eight residents assigned to the long-term care unit developed pressure injuries accounting for 0.19% of the residents in that unit. Postintervention data concluded that after implementing the Pressure Injury Prevention Injury Pathway for Acute Care bundle, the rate of acquired pressure injuries dropped to 9%, proving a 10% decrease in acquired pressure injuries in the long-term care unit consisting of fifty-eight long-term care residents.
Conclusion: Although the objective of reducing the rate of acquired pressure injuries to less than 3% in an eight-week timeframe was not achieved, the adoption of AHRQ's Pressure Injury Prevention Injury Pathway for Acute Care bundle proved to be more advantageous in minimizing the occurrence of acquired pressure injuries compared to the conventional approach of addressing such injuries only after they have occurred.
Keywords: pressure injury prevention bundle, pressure ulcers, long-term care, pressure injury prevention methods
Recommended Citation
Rhoden, LaTecia, "Implementing an Evidence-Based Pressure Injury Bundle to Reduce Acquired Pressure Injuries in a Long-Term Care Facility" (2023). Doctor of Nursing Practice Projects. 91.
https://digitalcommons.jsu.edu/etds_nursing/91