Introduction
This essay explores a change project aimed at reducing hospital-acquired pressure sores among admitted patients on bed rest or who are bed-bound. The specific focus is on whether rotating patients every two hours and padding bony prominences, compared to no such interventions, can decrease the incidence of pressure sores within a four-month period. Pressure sores, also known as pressure ulcers, are a significant concern in healthcare, contributing to patient discomfort and increased hospital costs (NHS Improvement, 2018). This essay will identify three crucial colleague roles for the project’s success, outline their involvement, and detail the preparation process. Additionally, it will present a timeline for implementation, associated actions, and a strategy for tracking progress. By addressing these elements, the essay aims to provide a structured approach to improving patient outcomes through evidence-based practice.
Key Colleague Roles and Their Involvement
Three colleague roles are pivotal to the success of this change project: registered nurses (RNs), healthcare assistants (HCAs), and the ward manager. Firstly, RNs are essential due to their clinical expertise and responsibility for patient care plans. They will lead the implementation of the rotation and padding protocol, assess patient skin integrity, and document outcomes (Royal College of Nursing, 2016). Secondly, HCAs are critical in supporting RNs by physically assisting with patient repositioning every two hours and ensuring padding is correctly applied. Their hands-on role ensures consistent application of interventions. Lastly, the ward manager will provide oversight, allocate resources, and address barriers to implementation, such as staffing shortages. Their leadership will ensure the project aligns with hospital policies and sustains momentum. Each role complements the others, creating a cohesive team to drive the change forward.
Preparation for the Change Project
Preparing colleagues for this change project involves education, communication, and fostering buy-in. Initially, I will conduct a series of training sessions to educate RNs and HCAs on the importance of pressure sore prevention, the evidence supporting two-hourly rotations, and proper padding techniques (Moore and Cowman, 2015). These sessions will include practical demonstrations to build confidence. For the ward manager, a one-on-one meeting will outline the project’s goals, resource needs, and potential challenges, ensuring their support. Furthermore, I will distribute written guidelines and visual reminders (e.g., posters) on the ward to reinforce the protocol. This multi-faceted approach aims to equip the team with the knowledge and tools needed while addressing potential resistance to change through open dialogue.
Implementation Timeline and Actions
The change project will span four months, with specific actions planned for each phase. In the first two weeks (Month 1), I will hold an initial team meeting to introduce the project, followed by the aforementioned training sessions for RNs and HCAs. By Week 3, the intervention will commence, with RNs and HCAs implementing the rotation and padding protocol. Weekly check-in meetings will occur throughout Months 2 and 3 to address challenges and provide refresher training if needed. In Month 4, a formal evaluation meeting will assess outcomes using data on pressure sore incidence. These structured actions ensure consistent implementation and allow for timely adjustments.
Tracking Progress Using the Timeline
Progress will be tracked against the established timeline through measurable indicators and regular feedback. Weekly check-ins will monitor adherence to the two-hourly rotation schedule and padding application, documented via a checklist. Additionally, RNs will record any new pressure sores weekly, comparing incidence rates to baseline data collected pre-intervention. These metrics will be reviewed during the monthly meetings to identify trends or issues. By Month 4, a comprehensive analysis of the data will determine the intervention’s effectiveness, ensuring accountability and providing evidence for potential wider adoption (NHS Improvement, 2018). This systematic tracking aligns with the timeline, facilitating a clear evaluation of the project’s impact.
Conclusion
In summary, this change project addresses the critical issue of hospital-acquired pressure sores through targeted interventions of patient rotation and padding. The involvement of RNs, HCAs, and the ward manager ensures a collaborative approach, supported by thorough preparation via training and communication. The four-month timeline, with structured actions like meetings and education, provides a clear roadmap for implementation. Progress tracking through checklists and incidence data offers a robust method to evaluate success. Ultimately, this project has the potential to improve patient outcomes, reduce healthcare costs, and contribute to evidence-based practice in pressure sore prevention. Further research could explore long-term sustainability and scalability of such interventions across different wards or hospitals.
References
- Moore, Z.E.H. and Cowman, S. (2015) Risk assessment tools for the prevention of pressure ulcers. Cochrane Database of Systematic Reviews, (2), CD006471.
- NHS Improvement (2018) Pressure Ulcers: Revised Definition and Measurement. NHS England.
- Royal College of Nursing (2016) Pressure Ulcer Risk Assessment and Prevention. RCN Guidelines. London: RCN.
