Evidence-Based Practice

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Recommended: executive summary on pressure ulcers

Part A

Think about your specific practice setting. Based on your new knowledge of evidence-based practice, pick one unit procedure in your work place and explore whether it is based on research evidence or not. Discuss what you think would be needed to make the procedure more in line with best practice in the area or what was done to ensure that it was based on best practice.

At Fremont-Rideout the big issue was pressure ulcers, every month all the patients in the hospital had to be assessed for them. Anything that was a stage 3 or above had to reported to AHS. According to Chaves, Grypdonck, & Defloor (2010, p. 563), evidenced-based protocols are specific to the organization, and are used to help improve patient outcomes. In 2009 the Wound Ostomy Continence Nurses Society (WOCN) established a basic guideline for organizations to go buy in order to prevent and treat pressure ulcers.

Therefore, in this case the evidenced-based practices are; assess for risk factors (use of Braden scale); assess bony prominences for skin breakdown; assess for appearance and changes in the color of the skin; stage and describe ulcer; measure and document ulcer; reposition patient every 2 hours; remove dressing once a shift to assess skin; and accurately document progression of wound healing. The best thing to do is to make sure that you assess each person’s skin every shift to make sure that they aren’t getting an ulcer, and use of the Braden Scale. For the person that has an ulcer you want to make sure that you’re taking off the bandages and checking with prior assessments to see if the ulcer is healing. If the ulcer isn’t healing then the doctor needs to be notified and the patient needs to be reevaluated on the proper treatment, in order for...

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... my point of view. I elicit information and ideas by asking open-ended questions; many times I forget to ask open-ended questions, since this can help elicit more information. It also makes the person feel as though you are including them.

Although I do possess many of these skills, there is always room for improvement, especially since there are different challenges that arise on a daily basis. I don’t believe that one is truly ever done learning.

References

Chaves, L. M., Grypdonck, M. H., & Defloor, T. (2010, March). Protocols for pressure ulcer prevention: are they evidence-based? Journal of Advanced Nursing, 66(3), 562-572. doi: 10.1111/j.1365-2648.2009.05227.x.

Wound, Ostomy, and Continence Nurses Society. (2009). Wound Ostomy Continence Nurses Society guidance on OASIS-C integumentary items. Retrieved from http://www.wocn.org/pdfs/GuidanceOASIS-C.pdf

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