NR439_W3_PPE WORKSHEET Gallo (1)

Problem/PICOT/Evidence Search (PPE) WorksheetName: Jeremy Gallo Date: 11/17/2019 Criteria In a Med-Surge unit I would see a lot of admissions mostly older geriatric people which mostly come from other places like nursing homes. . Nursing home residents who had high immobility (16%) had an 11% greater occurrence of pressure ulcers than those without high immobility (5%) (CDC). Sadly a lot of patients show up with pressure ulcers. . Pressure Ulcers have become a big health concern in the health industry. Nurses are trained to put certain practices in place to prevent ulcers. Original nursing research aims to generate new knowledge to inform the practice of nursing. (Houser,2018) if the skin care intervention strategies started in the Emergency Department patient outcome would be better and hospital costs would decrease. Re-educating Emergency Department nurses on properly assessing skin and the importance of early intervention in key.https://www.cdc.gov/nchs/products/databriefs/db14.htmHouser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Bur-lington, MA: Jones & Bartlett Learning.Clinical Nursing Practice ProblemSelect and identify ONLY one quality or safety clinical priority area from the assignment guidelines practice scenario. Summarize why you believe the nursing practice problem/issue is the most important. Summarize your rationale (why) for choosing the problem. Clinical Nursing PICOT QuestionUsing the NR439 Guide for Writing PICOT Questions and Examples located in the assignment guidelines, write out your PICOT question. Include the PICOT letters in your question. Adult patients who are non-ambulatory arrive to the Emergency Depart-ment(P), does pressure ulcer prevention begin upon arrival of the Emergency De-partment(I) compared to not identifying or using pressure ulcer prevention proto-cols(C) affect hospital acquired pressure ulcers and to lower cost of treating a pres-sure ulcer(O)during the Emergency Department stay and possible hospital admis-sion(T)?Define PICOT ElementsDefine each of the PICOT elements from your question above. P- Geriatric Patients who are non-ambulatory that come to the Emergency Department. I- Initiating pressure ulcer prevention treatments upon arrival to the Emergency De-apartment.C- Not using pressure ulcer preventionO- Limit the number hospital acquired pressure ulcers that could’ve been preventedT- Emergency Department admission Evidence Retrieval Process and Summary Using only the Chamberlain College of Nursing library: (1) Locate evidence that is relevant to your chosen nursing practice problem. Explain how you believe the evidence is relevant to your chosen nursing practice problem. (2) Explain why you chose the evidence(3) Provides a complete APA reference to the evidence (must include authors, year, title of the evidence, title of the resource) (4) Evidence must be published within the last 10 years(5) Provides the permalink ARENDTS, GLENN(2017)How comprehensive is comprehensive enough? Emergency Department assessment of older people. Age & Ageing (AGE AGEING), May2017; 46(3): 340-341. (2p) Retrieved from:http://dx.doi.org.chamberlainuniversity.idm.oclc.org/10.1093/ageing/afw258The above article supports my research by explaining the importance and lack of proper geriatric assessment in the Emergency Department. “It is increasingly apparent that the environment, staffing and operational rules of EDs in the era of time-based targets do not optimally meet the needs of frail older people presenting for hospital care.”(Arendts.Glenn) I chose this evidence because assessing the elderly and non-ambulatory patients the correct and most efficient way plays a significant part on the safety and future care of these patients. I believe this article will help support my research topic.Denby A, & Rowlands A. (2010). Stop them at the door: should a pressure ulcer prevention protocol be implemented in the emergency department? Journal of Wound, Ostomy & Continence Nursing, 37(1), 35–38. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1097/WON.0b013e3181c68b4bThe research in the above article was performed to compare the correlation between length of stay in the ED and patients who acquired pressure ulcers in the hospital who were directly admitted to the hospital from the ED. The results were calculated by collecting data from patients were came to the ED. In 2006 32,664 patients came to the ED seeking medical attention. It was calculated that 75% of the total patient population admitted was admitted from the ED. 125 of those patients went on to develop hospital-acquired pressure ulcers, that’s a staggering… 99.2% The ED length of stay was greater than 2 hours prior to hospital admission. This evidence supports my research by showing Evidence based practice and the importance for early nursing interventions to prevent hospital-acquired pressure ulcers.Implications of the EvidenceSummarize what you learned from the evidence. Summarize why you believe the nursing evidence-based practice committee should focus their next research project on the nursing practice problem. The purpose of this research is to ensure patient safety by properly educating nurses in the Emergency Department early skin care intervention protocols to patients who are high risk. We need to educated nurses how to recognize possible skin issues. The earlier the interventions are implemented the better the outcome. As a healthcare professional it is our responsibility to provide effective care. Sick people are very vulnerable and come into hospital frightened. Their lives are in our hands and they fully trust that we would do the best of our ability to advocate for them. The best thing we can do to ensure our patients care and safety is practicing our professional responsibility, by following Evidence Based Practice. The early prevention of pressure ulcers reduces pain, lengths of stay and complications for patients. (Fagan)Fagan, Marie, “Early Prevention of Pressure Ulcers in the Emergency Department” (2015).Seton Hall University DNP Final Projects. 10. https://scholarship.shu.edu/final-projects/10Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Burlington, MA: Jones & Bartlett Learning.Evidence Search TermsIdentify 4 (or more) relevant searchable terms you used for your search for evidence. I will research the following four areas to search for evidence regarding most recent research about nursing interventions and early education to ED nurses regarding the importance of early skin care assessment during ED stay. What is the current policy on the ED assessing and documenting wounds? What are the benefits for the interventions listed in the PICOT (nurse education, patient safety, better patient care outcome, lower cost of hospital stays)? Do any regulatory protocols exist regarding these nursing education topics? What is the current understanding among nursing experts regarding these topics?The keywords used were: (1) early detection of pressure ulcers (2) pressure ulcers (3) emergency room prevention of pressure ulcers (4) early intervention of pressure ulcers (5) the elderlyEvidence Search StrategiesSelect 4 (or more) relevant search strategies you used to narrow/limit your search for Evidence. ___X_ Full text____ Boolean Operators/Phrase__X__ Selected publication dates within last 10 years___X_ Subject, title, or author search box____ Truncation (used an asterisk * at the beginning or end of a word) ___X_ Academic or scholarly (Peer Reviewed) journals____ Quotation marks for key words___X_ Selected key terms from PICOT question____ Others: (list below) ______________________________________________________________

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