Date of Conferral

2-26-2026

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Barbara Niedz

Abstract

This project addressed the critical practice problem of formation of Stage III/IV pressure injuries in adult patients admitted to the long-term acute care (LTAC) intensive care unit (ICU) department, which has been linked to increased lengths of stay, mortality rates, and treatment costs for the facility. Thus, development of a clinical practice guideline (CPG) focused on a nurse-driven protocol to identify patients in the ICU department at high risk of developing a Stage III/IV pressure injury and initiating prevention measures formed the primary purpose of the Doctor of Nursing Practice (DNP) project. The practice focused question addressed whether an evidence-based CPG that is nurse-driven would be accepted for implementation in practice at an LTAC facility by a panel of experts for Stage III/IV pressure injury prevention. The Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument was used to evaluate the newly created CPG. Seven members of an expert panel provided the review and included the medical director of the facility, along with other experts in the field of wound care. The AGREE II tool was used by the expert panel to appraise and unanimously approved the CPG in this project. The decision to approve the pressure injury prevention CPG will aid in addressing the gap in practice identified in the ICU department of the LTAC facility and allow for better management of high-risk patients. Thus, the implementation of this CPG has the potential to impact care across diverse health care environments by providing a standardized evidence-based guideline for the prevention of pressure injuries in high-risk individuals, which addresses diversity, equity and inclusion, and represents a significant positive social change.

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