Sample Healthcare Paper on Hospital-Acquired Pressure Injuries

Background

Hospital-acquired pressure injury (HAPI) is also known as a pressure ulcer. HAPI is believed to mostly occur during an inpatient hospital stay, and it is identified as a localized injury to the skin or underlying tissue. The severity of the pressure and shear on an individual’s skin or underlying tissue is related to other factors such as the presence of diabetes, advanced age, nutritional status, illness severity, and others. Hospital-acquired pressure injuries are accepted as nursing quality indicators and are generally preventable. HAPI can result in a longer stay in the hospital, infection, pain, and death of a patient. According to the Centers for Medicare and Medicaid Services (CMS), HAPI rates across the United States have decreased from 40.3 to 30.9 per 1000 discharges between 2015 and 2019. The decrease in the rates of HAPI across the country shows that health organizations have put concerted efforts to prevent the injury through the use of risk assessment. Despite advances in prevention and treatment of HAPI, it is still challenging to eliminate the injuries.

Literature Review

A few studies exist that critique the issue of hospital-acquired pressure injuries. One of the recent studies is “Pressure Injury” that critiques that HAPI affects individuals of any age, and it is majorly experienced in all health settings. The article further argues that HAPI has imposed a significant financial burden on the U.S, and it is estimated that the country has spent $17.8 billion to deal with this particular issue (Hajhosseini, Longaker, & Gurtner, 2020). Despite the financial burden that the disease has imposed on the U.S, the article asserts that incidence related to the issue are on the rise. The article asserts that the rise in the incidence of the disease is due to the growing number of nursing homes, the aging population, among other factors. According to Lin, Wu, Song, Coyer & Chaboyer, (2020), pressure ulcers are frequently occurring adverse events but they are preventable. Patients at intensive care units have major risk factors for pressure ulcer with a reported prevalence 12 to 33 percent (Lin, Wu, Song, Coyer & Chaboyer, 2020). Goodwin & Demner-Fushman, (2020), asserts that an effective healthcare system allows the use of clinical text to predict Hospital-Acquired Pressure Injuries. The article hypothesizes on the benefit of clinical text as it can help improve the delivery of care to HAPI patients (Goodwin & Demner-Fushman, 2020).  According to Barakat-Johnson et al, (2020), applying the promoting action on research implementation plan in health services (PARIHS) can help in the fight against HAPIs. The article asserts that the plan not only help to reduce incidence of pressure injuries in health settings, but also it helps in promoting positive practice that may lead to improved patient outcomes.

Purpose

The purpose of this study is to describe how HAPI incidence, its risk factors, and the prevention strategies related to this particular disease. The setting of the work is set to be an integrated healthcare delivery system, Kaiser Permanente, which comprises of at least 8 million members.

Methods

The methods to be used in the study to address the incidence and risk factors of HAPI across U.S.  include re-education of the Braden scale to help nurses in assessing a patient’s risk of developing pressure ulcers, formulating a quick guide for unit RN’s to utilize when assessing the outcomes, offering wound care class to all RN’s, and adding skincare champion to help with the monthly unit skin assessments.

Outcomes

Applying these methods will help in reducing the decrease in pressure injury incidences thereby leading to improved patient outcomes in a shorter time frame than the previous studies. Pressure injuries incidences in various health settings across the U.S. are approximated at 4 percent. The objective of the study is to reduce this rate of HIPA across the country to 0 percent.

Implications

The objective of the study is to develop a plan on how medical evidence can be translated into nursing practice. Besides, the study aims to assist nurses by providing them with guidelines associated with how they can promote optimal care to patients living with hospital-acquired pressure injuries. Furthermore, this study can be transferred to various health settings to help in providing guidelines on how to improve the health status of HAPI patients. This study can be used for future healthcare-quality research to determine the most effective strategies related to prevention of HAPIs.

 

References

Barakat-Johnson, M., Lai, M., Wand, T., Coyer, F., & White, K. (2020). Systemwide Practice Change Program to Combat Hospital-Acquired Pressure Injuries: Translating Knowledge into Practice. Journal of Nursing Care Quality, 35(1), 51-57. https://doi.org/10.1097/ncq.0000000000000395

Goodwin, T. R., & Demner-Fushman, D. (2020). A customizable deep learning model for nosocomial risk prediction from critical care notes with indirect supervision. Journal of the American Medical Informatics Association, 27(4), 567-576.https://doi.org/10.1093/jamia/ocaa004

Hajhosseini, B., Longaker, M. T., & Gurtner, G. C. (2020). Pressure Injury. Annals of Surgery, 271(4), 671-679.https://doi.org/10.1097/SLA.0000000000003567

Lin, F., Wu, Z., Song, B., Coyer, F., & Chaboyer, W. (2020). The effectiveness of multicomponent pressure injury prevention programs in adult intensive care patients: A systematic review. International Journal of Nursing Studies, 102, 103483.https://doi.org/10.1016/j.ijnurstu.2019.103483