DNP 835 Reflecting on the “IHI Module QI 202: Addressing Small Problems to Build Safer, More Reliable Systems,” describe how your direct practice improvement project achieves clinical improvement

 DNP 835 Reflecting on the “IHI Module QI 202: Addressing Small Problems to Build Safer, More Reliable Systems,” describe how your direct practice improvement project achieves clinical improvement

Enhancing the quality and safety of health care is a main concern of governments, health care workers, and the public with endeavors often concentrated on contributions made towards having changes in how health care is structured and provided. Quality improvement projects have been done continuously in healthcare settings in an effort to enhance the quality of care of individuals, improve the health of community members and reduce healthcare costs thus attaining clinical improvement (Hill et al., 2020). Wounds can add substantially to healthcare costs and influence healthcare professionals’ time. The use of Mepilex Border dressings in hospital-acquired pressure injuries (HAPI) has been mentioned to achieve clinical improvement and has been clinically effective in numerous studies (Santamaria et al., 2018; Hahnel et al., 2020; Padula, 2017). Hill et al. (2020) mentioned that by decreasing the number of dressing changes, Mepilex foam dressings protect the wound, assure optimal healing, lowers material costs, and increase health service efficiency by releasing healthcare practitioners’ time to care for patients. This absorbent single dressing enables a longer wear time retains exudate, and avoids wound maceration and associated complications.

Widespread change can be accomplished through continuous professional education to ensure that healthcare professionals’ competencies, knowledge, and skills are aligned with current standards and evidenced-based practice (Nilsen et al.,2020). In Australia, a country with universal health care, foam dressing was compared with other absorbent dressings and was mentioned to be cost-effective when compared to saline dressings in treating HAPI (Walker et al., 2017). Padula (2017) was applicable in describing the usefulness of the foam sacral dressing and its cost-effectiveness in a country without Universal Health Coverage, the United States. This was a concern for this scholar’s DPI project, but the study highlighted its effectiveness when used prophylactically and financially and hence can be translated into practice to support this DPI project. This foam dressing will be initiated into a long-term care setting using Lewin’s theory of change over a period of eight weeks. The dressing is available at the facility however there is no policy providing the wound nurse with specific guidelines on its use. Hence, it is the aim of this DPI project to translate the use of the Mepilex foam dressings into practice and to continually educate staff on its usage.

References

Hahnel, E., El Genedy, M., Tomova-Simitchieva, T., Hauß, A., Stroux, A., Lechner, A., Richter, C., Akdeniz, M., Blume-Peytavi, U., Löber, N., & 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. The British Journal of Dermatology, 183(2), 256– 264. https://doi.org/10.1111/bjd.18621

Hill, J.E., Stephani, AM., Sapple, P. et al.  (2020). The effectiveness of continuous quality improvement for developing professional practice and improving health care outcomes: a systematic review. Implementation Science, 15, 23. https://doi.org/10.1186/s13012-020-0975-2

Nilsen, P., Seing, I., Ericsson, C., Birken, S. A., & Schildmeijer, K. (2020). Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses. BMC Health Services Research, 20(1), 147. https://doi.org/10.1186/s12913-020-4999-8

Padula W. V. (2017). Effectiveness and Value of Prophylactic 5-Layer Foam Sacral Dressings to Prevent Hospital-Acquired Pressure Injuries in Acute Care Hospitals: An Observational Cohort Study. Journal Of Wound, Ostomy, and Continence Nursing: Official Publication of The Wound, Ostomy and Continence Nurses Society, 44(5), 413–419. https://doi.org/10.1097/WON.0000000000000358

Santamaria, N., Gerdtz, M., Kapp, S., Wilson, L., & Gefen, A. (2018). A randomised controlled trial of the clinical effectiveness of multi-layer silicone foam dressings for the prevention of pressure injuries in high-risk aged care residents: The Border III Trial. International Wound Journal, 15(3),