DNP 815 Final PICOT-D Approval Form

DNP Learner Name                                                                                                                                                    Current Course 815A

PICOT-D Question Template
P	Population	Elderly and debilitated patients in a long-term-care facility
I	Intervention	Preventive care bundle
C	Comparison	Routine pressure ulcer prevention
O	Outcome	Reduce the incidence of pressure ulcer
T	Timeline	Within 60 days
D	Data	Electronic Health Record, research databases
What is your licensure?	APRN                                               RN   Is this practice change within the scope of your nursing practice?   YES       No   By submitting this form, I am attesting I have read my state’s Nurse Practice Act, and the project is within the scope of my practice.
PICOT	For elderly and debilitated patients [P], will the implementation of a pressure preventive bundle [I], compared to routine pressure injury care [C], reduce the incidence of pressure injury [O], within 60 days? [T].
Problem Statement	Pressure ulcers are a considerable risk to elderly and debilitated patients’ safety in long-term care facilities. They threaten patients’ safety and care quality by increasing morbidity, hospitalization, and discomfort (Darvall et al., 2018; Pickham et al., 2018). Nurses apply multiple strategies to prevent pressure ulcers or minimize their impacts. Preventive pressure bundles include measures such as regular patient turns/ repositioning, skin inspection, checking support services, and risk assessment (Lavallée et al., 2019; Yap et al., 2021). It is not known if the implementation of pressure preventive bundle would impact pressure ulcer prevention among elderly and debilitated patients in a long-term-care facility. Implementing the project will help to determine the effectiveness of the preventive pressure bundle in reducing the incidence of pressure ulcers.
Purpose Statement	The purpose of this quality improvement project is to determine if the implementation of a care bundle intervention would impact pressure ulcer prevention among elderly and debilitated patients when compared to current practice in a long-term-care facility in a suburban Maryland city within 60 days.
Original Research articles: List all original research articles that support the intervention (Required) Ensure there is a permalink to the research articles. Attach the articles to the email submission to the PICOT Team Week 8 and all subsequent submissions.	Darvall, J. N., Mesfin, L., & Gorelik, A. (2018). Increasing frequency of critically ill patient turns is associated with a reduction in pressure injuries.             Critical Care and Resuscitation, 20(3), 217-222. https://europepmc.org/article/med/30153784. Hahnel, E., El Genedy, M., Tomova‐Simitchieva, T., Hauß, A., Stroux, A., Lechner, A., … & Kottner, J. (2020). The effectiveness of two silicone dressings for sacral and heel pressure ulcer prevention compared with no dressings in high‐risk intensive care unit patients: A randomized controlled parallel‐group trial. British Journal of Dermatology, 183(2), 256-264. https://doi.org/10.1111/bjd.18621 Lavallée, J. F., Gray, T. A., Dumville, J., & Cullum, N. (2019). Preventing pressure ulcers in nursing homes using a care bundle: A feasibility study. Health & Social Care in the Community, 27(4), e417-e427. https://doi.org/10.1111/hsc.12742 Pickham, D., Berte, N., Pihulic, M., Valdez, A., Mayer, B., & Desai, M. (2018). Effect of a wearable patient sensor on care delivery for preventing pressure injuries in acutely ill adults: A pragmatic randomized clinical trial (LS-HAPI study). International Journal of Nursing Studies, 80, 12-19. https://doi.org/10.1016/j.ijnurstu.2017.12.012. Yap, T. L., Horn, S. D., Sharkey, P. D., Zheng, T., Bergstrom, N., Colon-Emeric, C., … & Kennerly, S. M. (2021). Effect of varying repositioning frequency on prevention of pressure injuries in nursing home residents: TEAM‐UP cluster‐randomized clinical trial results. Research Square, 1-21. https://doi.org/10.21203/rs.3.rs-717425/v1

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References

Darvall, J. N., Mesfin, L., & Gorelik, A. (2018). Increasing frequency of critically ill patient turns is associated with a reduction in pressure injuries.

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            Critical Care and Resuscitation, 20(3), 217-222. https://europepmc.org/article/med/30153784.

Hahnel, E., El Genedy, M., Tomova‐Simitchieva, T., Hauß, A., Stroux, A., Lechner, A., … & Kottner, J. (2020). The effectiveness of two silicone dressings for sacral and heel pressure ulcer prevention compared with no dressings in high‐risk intensive care unit patients: A randomized controlled parallel‐group trial. British Journal of Dermatology, 183(2), 256-264. https://doi.org/10.1111/bjd.18621

Lavallée, J. F., Gray, T. A., Dumville, J., & Cullum, N. (2019). Preventing pressure ulcers in nursing homes using a care bundle: A feasibility study. Health & Social Care in the Community, 27(4), e417-e427. https://doi.org/10.1111/hsc.12742

Pickham, D., Berte, N., Pihulic, M., Valdez, A., Mayer, B., & Desai, M. (2018). Effect of a wearable patient sensor on care delivery for preventing pressure injuries in acutely ill adults: A pragmatic randomized clinical trial (LS-HAPI study). International Journal of Nursing Studies, 80, 12-19. https://doi.org/10.1016/j.ijnurstu.2017.12.012.

Yap, T. L., Horn, S. D., Sharkey, P. D., Zheng, T., Bergstrom, N., Colon-Emeric, C., … & Kennerly, S. M. (2021). Effect of varying repositioning frequency on prevention of pressure injuries in nursing home residents: TEAM‐UP cluster‐randomized clinical trial results. Research Square, 1-21. https://doi.org/10.21203/rs.3.rs-717425/v1