Quality Improvement: Pressure Ulcers

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Quality improvement issues in healthcare focus on the care that patients receive and the outcomes that patients experience. Nurses play a major advocacy role for ensuring safe and quality care to all patients. Also, nurses share the responsibility in leading the efforts in improving patient care in all settings (Berwick, 2002). One of the ongoing problems plaguing hospitals and nursing homes is the development of new pressure ulcers in patients after admission. A pressure ulcer can be defined as a localized area of necrotic tissue that is likely to occur after soft tissue is compressed between a bony prominence and a surface for prolonged periods of time (Andrychuk, 1998). According to the Centers for Medicare and Medicaid, patients should never develop pressure ulcers while under the supervision of any medical institution because they are totally preventable (Berwick, 2002). The purpose of this paper is to discuss the problems associated with pressure ulcers, examine the progress on improving this specific issue, and explain the Plan, Do, Study, Act cycle that I would use to improve patient care in this area.
Discussion
Problem: Pressure Ulcers
The reduction of pressure ulcer prevalence rates is a national healthcare goal (Lahmann, Halfens, & Dassen, 2010). Pressure ulcer development causes increased costs to the medical facility and delayed healing in the affected patients (Thomas, 2001). Standards and guidelines developed for pressure ulcer prevention are not always followed by nursing staff. For example, nurses are expected to complete a full assessment on new patients within 24 hours at most acute-care hospitals and nursing homes (Lahmann et al., 2010). A recent study on the causes of pressure ulcer de...

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Berwick, D. M. (2002). A user's manual for the IOM's 'quality chasm' report. Health Affairs, 21(3), 80-90. Retrieved from http://search.proquest.com/docview/204628853?accountid=
14472
Institute for Healthcare Improvement. (2014). How to improve. Retrieved from https://www.ihi. org/resources/Pages/HowtoImprove Lahmann, N. A., Halfens, R. J. G., & Dassen, T. (2010). Impact of prevention structures and processes on pressure ulcer prevalence in nursing homes and acute-care hospitals. Journal of Evaluation in Clinical Practice, 16(1), 50-56. doi:http://dx.doi.org/10.1111/
j.1365-2753.2008.01113.x
Thomas, D. R. (2001). Issues and dilemmas in the prevention and treatment of pressure ulcers: A review. The Journals of Gerontology, 56A(6), M328-40. Retrieved from http://search. proquest.com/docview/208635333?accountid=14472

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