Date of Conferral

2018

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Mary T. Verklan

Abstract

Pressure injuries (PIs) affect an estimated 2.5 million people in America and cost the nation approximately $11.6 billion each year. The goal of this DNP project was to minimize the rate of PIs at a home health care agency through effective teamwork. Prevention of PIs is very important because PIs damage patients' skin integrity, cause significant amount of pain, are costly to treat, and cause life-threatening infections. The purpose of this DNP project was to evaluate nursing compliance with PI prevention measures and the level of nursing teamwork at the project agency. The Braden-Bergstrom conceptual framework was used to explain the etiology and progression of PI while Lewin's Change Theory was used to promote behavioral change in the nursing team. The practice-focused questions for closing the gap between nursing knowledge and practice were what percentage of nurses complied with standard PI prevention guidelines and what was the level of nursing staff teamwork in the agency per the Nursing Teamwork Survey [NTS]. This PI prevention initiative used a cross-sectional design. Data collection involved review of nursing documentation and electronic surveying of all nursing staff using the MISSCARE survey, the NTS, and the AHRQ assessment checklists, which were completed via SurveyMonkey, an online survey software. The impact of the PI prevention initiative was assessed by comparing the results of the documentation review and surveys pretest to the posttest results. There was significant improvement in nursing compliance with PI prevention and treatment. Pressure injury incidence rate fell from 13.6% to 5.1%. The positive social impact includes improving patient care and safety, minimizing PI incidence and producing an efficient team.

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