Module 1 Assignment Description

Before submitting your project overview, please e-mail your overview to your instructor for approval. Once the overview has been approved, you may submit the overview to the dropbox for grading.

Submit a project overview based on the guide provided in module 1.

When you have received approval from your capstone mentor (faculty), you can proceed to complete the project overview submission. The overview that is submitted will become the blueprint to follow for your project manuscript.

Write a 1500-word essay addressing each of the following points. There should be a section for each bullet below. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing. Support your ideas with at least three (3) sources in your essay. Make sure to reference the citations using the APA writing style for the essay. The cover page and reference page do not count towards the minimum word amount.

Project Title – should appear on the title page of the paper.
Project Description
Project Rationale
Personal/Professional Expectations
Project Goals
Analysis of the Literature
Procedure
Findings

Expert Answer and Explanation

Prevention of Pressure Ulcers in Senior Population

A pressure ulcer is a localized injury resulting in constant pressure to underlying tissue and skin (McGraw, 2019). The ulcers often happen over bony prominences, such as ischial tuberosities, sacrum, lateral malleoli, heels, and greater trochanters. Pressure ulcers are most common in older individuals. Arizona Center on Aging (2015) reports that more than 70% of pressure ulcers cases happen in older individuals aged 65 years and above. Hospitals records about 32% of cases of pressure ulcers, and nursing home residents record about 22% of the cases (Arizona Center on Aging, 2015). Agency for Healthcare Research and Quality (AHRQ) (n.d) reports that more than 2.5 million cases of pressure ulcers are reported in the US yearly. The agency also notes that pressure ulcer has increased the cost of care among older people. The agency reports that individuals end up paying 20,900 to 151,700 per pressure ulcer. The agency also reports that pressure ulcer is the cause of about 60,000 deaths yearly in the US. Based on the statistics above, a pressure ulcer is a serious health issue, especially among older people, and should be addressed. Pressure ulcers among older people will be the focus of this project.

Project Description

This project will be about reducing incidences of pressure ulcers among geriatric patients. The project will explore whether educating nurses about pressure ulcers prevention strategies can reduce pressure ulcers in the geriatric population. Statistics show that older people are the population with the highest number of pressure ulcer incidences. Jaul et al. (2018) note that pressure ulcers are common among older people because they are more likely to be hospitalized than other populations. The authors note that many older people suffer frailty, multiple diseases, and disability, resulting from transferring to nursing home residencies and hospitalizations. Older people exhibit declined physiological reserve, which leads to chronic diseases that make them immobile. Lying and being immobile for long periods contribute to the appearance and development of pressure ulcers (McGraw, 2019). Older people are the project’s focus because they exhibit prolonged chronic diseases that contribute to weight loss and immobility and thus increase their exposure to pressure ulcers.

Project Rationale

This project is vital in nursing practice. After its completion, nurses will know how to prevent pressure ulcers among geriatric patients. The project will also increase the body of literature about pressure ulcers and their prevention strategies. The project is also necessary because of the magnitude of incidences of pressure ulcers in the geriatric population. Nurses are required to provide quality and safe care that achieves patients’ desired outcomes. However, pressure ulcers often prevent them from achieving this goal. Hence, the project is necessary to improve the quality of care older people receive.

Personal/Professional Expectations

My expectation about this project is that it will improve my knowledge of preventing pressure ulcers in the geriatric population. Another personal expectation is that the project will improve the quality of care among geriatric patients. The professional expectation is that the project help nurses provide safe, quality, efficient, and cost-effective care. After implementation of the project, incidences of pressure ulcers in the geriatric department should reduce.

Project Goals

The first goal of the project is to reduce incidences of pressure ulcers in the geriatric population.
The second goal of the project is to reduce the length of hospital stay. Pressure ulcers increase the days patients spend in hospital settings (Jaul et al., 2018).
The last goal is reducing the cost of care among the geriatric population. AHRQ reports that pressure ulcers are known for increasing the cost of care.

Analysis of the Literature

Risk Factors of Pressure Ulcers

A study by Ghali et al. (2018) shows that there several risk factors for pressure ulcers. The study found that age is one of the risk factors for pressure ulcers. The authors note that people experience undernutrition and low body mass index, and thus increases their chances of contracting pressure ulcers. Another risk factor is pathology leading to immobility. Disorders of higher functions and polytrauma are pathologies that lead to immobility and increase people’s risks of suffering pressure ulcers (Ghali et al., 2018). Neurological diseases and underlying chronic conditions, such as diabetes, stroke, and sliding syndrome, are also risk factors of pressure ulcers. González‐Méndez et al. (2018) note that longer hospital stay is also a risk factor of pressure ulcers. The authors found that patients who had stayed in the ICU for more than 1000 days had higher rates of pressure ulcers. The authors also found that the length of immobilization is also a risk factor for pressure ulcers. Han et al. (2017) note that patients with pressure ulcers often have underlying health issues and are older. Patients with spinal cord injuries also risk developing pressure ulcers. It is safe to argue that old age is the primary risk factor for pressure ulcers based on the literature. Hence, most interventions about pressure ulcers should be directed to the senior population.

Complications of Pressure Ulcers

Patients with pressure ulcers risk experiencing many medical complications. Han et al. (2017) report that patients with pressure ulcers risk developing wound complications that can be hard to treat. Pressure ulcers often start as small manageable wounds. However, if not treated on time, the sores might develop into complicated wounds. 14% of the patients with pressure ulcers reported wound complications (Han et al., 2017). Patients with pressure ulcers also risk developing a condition known as bacteremia (Espejo et al., 2018). Bacteremia is a condition where germs are in the circulating blood. The disease can cause many health problems, including abdominal pain, fever, diarrhea, and breathing issues. If not controlled on time, the disease can lead to death. Espejo et al. (2018) also report that patients with pressure ulcers also risk developing complications, such as osteomyelitis, abscess, and cellulitis. Individuals with pressure ulcers also risk developing joint and bone infections. They also risk developing sepsis. Therefore, pressure ulcers should be managed as soon as it is discovered.

Impact of Pressure Ulcers on Quality of Care

Pressure ulcers negatively impact the quality of care. Pressure ulcers can produce pain and make a patient under care feel a lot of discomforts (Han et al., 2017). Patients come to healthcare facilities to get help for health problems they are facing. Instead of experiencing relief, pressure ulcers add discomfort to the patient by increasing the level of pain. Pressure ulcers also impact the quality of care by increasing the cost of health services. One of the characteristics of quality of care is cost-effective services. However, AHRQ (n.d) reports that patients pay more than $40,000 more for pressure ulcers treatment. Pressure ulcers increase the cost of care by requiring patients to stay longer in healthcare facilities and pay for additional care services. The disease also affects the quality of care by negatively impacting patients’ safety. Espejo et al. (2018) note that patients with pressure ulcers and who have other comorbid disorders are more likely to die.

Procedure

This project will be conducted using a quantitative research method. This method allows for collecting statistical data about opinions, attitudes, and behaviors (Reaves, 1992). The method has also been selected because it can improve the generalizability of the project findings. Results are highlighted in the quantitative method using statistical and mathematical instruments. The quantitative method has been considered over the qualitative method because of its statistical ability. Data collected statistically is often reliable than non-numerical data. The quantitative method can allow for authentication of the findings in that different individuals can run the data, and the same results will be found. The method is also more scientific (Holton & Burnett, 2005). Lastly, the qualitative method has been preferred because it allows for the arrangement of data in charts, tables, or figures, thus improving findings’ readability. The design for this study is quasi-experimental.

The first procedure will be to review the literature and use the collected data to support the background and purpose of the project. Second, the project’s objectives will be designed, and clinical questions that will guide it will also be developed. The third step is determining the methodology and design for the project. The project will be conducted using a quantitative research method and quasi-experimental design. The fourth step is data collection. Data will be collected using a questionnaire instrument. The fifth step is an analysis of data. Data will be analyzed using the descriptive analysis method. The last step is documenting the findings.

Findings

The project will explore whether nurse education about better bedside care strategies can reduce pressure ulcers in geriatric care. Various studies have confirmed that nurse education is significant in pressure ulcers prevention. Ünver et al. (2017) note that surgical nurses can better prevent pressure ulcers if they have a better attitude towards the problem. The authors found that additional education positively affects nurses’ attitude and thus improves their morale to prevent pressure ulcers. Saleh et al. (2019) note that nurses with knowledge of preventing pressure ulcers are more likely to implement it and improve patients. It can be safely argued that nurse education plays a key role in pressure ulcer prevention.

Conclusion

A pressure ulcer is a serious health issue, especially among older people, and should be addressed. The project will explore whether educating nurses about pressure ulcers prevention strategies can reduce pressure ulcers in the geriatric population. The project will also increase the body of literature about pressure ulcers and their prevention strategies.

References

Agency for Healthcare Research and Quality. (n.d). Preventing pressure ulcers in hospitals. https://www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/pu1.html

Arizona Center on Aging. (2015). Elder care interprofessional provider sheets: Pressure ulcers in older adults. https://www.uofazcenteronaging.com/care-sheet/providers/pressure-ulcers-older-adults

Espejo, E., Andrés, M., Borrallo, R. M., Padilla, E., Garcia-Restoy, E., & Bella, F. (2018). Bacteremia associated with pressure ulcers: A prospective cohort study. European Journal of Clinical Microbiology & Infectious Diseases, 37(5), 969-975. https://doi.org/10.1007/s10096-018-3216-8

Ghali, H., Rejeb, B., Chelly, S., Cheikh, A. B., Khefacha, S., & Latiri, H. (2018). Incidence and risk factors of pressure ulcers in a Tunisian University Hospital. Rev Epidemiol Sante Publique, 66(Supl 5), S340. https://doi.org/10.33805/2573.3877.133

González‐Méndez, M. I., Lima‐Serrano, M., Martín‐Castaño, C., Alonso‐Araujo, I., & Lima‐Rodríguez, J. S. (2018). Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit. Journal of Clinical Nursing, 27(5-6), 1028-1037. https://doi.org/10.1111/jocn.14091

Han, H. H., Ko, J. G., & Rhie, J. W. (2017). Factors for postoperative complications following pressure ulcer operation: stepwise multiple logistic regression analysis. International Wound Journal, 14(6), 1036-1040. https://doi.org/10.1111/iwj.12754

Holton, E. F., & Burnett, M. F. (2005). The basics of quantitative research. Research in organizations: Foundations and methods of inquiry, 29-44.

https://nursingandhealth.asu.edu/sites/default/files/pressure-ulcers.pdf

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.

McGraw, C. A. (2019). Nurses’ perceptions of the root causes of community‐acquired pressure ulcers: Application of the Model for Examining Safety and Quality Concerns in Home Healthcare. Journal of Clinical Nursing, 28(3-4), 575-588. https://doi.org/10.1111/jocn.14652

Reaves, C. C. (1992). Quantitative research for the behavioral sciences. John Wiley & Sons.

Saleh, M. Y., Papanikolaou, P., Nassar, O. S., Shahin, A., & Anthony, D. (2019). Nurses’ knowledge and practice of pressure ulcer prevention and treatment: An observational study. Journal of tissue viability, 28(4), 210-217. https://doi.org/10.1016/j.jtv.2019.10.005

Ünver, S., Fındık, Ü. Y., Özkan, Z. K., & Sürücü, Ç. (2017). Attitudes of surgical nurses towards pressure ulcer prevention. Journal of Tissue Viability, 26(4), 277-281. https://doi.org/10.1016/j.jtv.2017.09.001

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