Pressure ulcers (PU) occur when the skin and the underlying tissue are damaged due to persistent pressure, primarily on the skin covering the heels, ankles, hips, and tailbone. PU mostly occurs among elderly patients due to deteriorating mobility, nutritional deficit, and physical challenges due to severe chronic diseases
Objective
Create and present your full project.
Deliverables
Create a PP Presentation with narration in presenter notes for your project.
Step 1: Capstone Project
Create a PP Presentation.
Step 2: Consider
Must be no more than 15 slides
Title slide
Introduction side
Purpose slide
Literature review slides
Outcomes slide
Approach slide
Budget slide
Strategies slide
Results slide
Reference slide
Conclusion slide
Must include professional narration
Step 3: Create
Use the template attached below.
Step 4 Save and submit
When you have completed your assignment, save a copy for yourself in an easily accessible place and submit a copy to your instructor using Dropbox.
Feel free to refer to the template linked below for help with this project.
Template Sample for PPT.pptxDownload Template Sample for PPT.pptx
This presentation may be used publicly. If so, you will be contacted by email for permission.
Post Licensure BSN Assignment 9.2019
Post Licensure BSN Assignment 9.2019
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeIntentional Learning and Reflection
15 pts
Exemplary
Identifies/addresses a relevant topic and a thesis that provides direction for the content that is engaging and thought provoking. The thesis clearly and concisely states the position, premise, or hypothesis and is consistently the focal point throughout the presentation. Demonstrates a sophisticated understanding and careful, critical analysis of the research topic and thesis (argument). Compares/contrasts perspectives, considers counter arguments or opposing positions, and draws original and thoughtful conclusions with future implications.
10 pts
Accomplished
Identifies/addresses a relevant topic and a thesis that provides adequate direction for the content with some degree of interest for the reader. The thesis states the position, premise, or hypothesis, and is the focal point of the paper for the most part. Demonstrates an understanding and some critical analysis of the research topic and thesis (argument). Adequately compares/contrasts perspectives, counter-arguments, or opposing positions but broader connections and/or implications are not as thoroughly explored
5 pts
Developing
Identifies a research topic but may be too broad in scope and/or the thesis is somewhat unclear and needs to be developed further. Focal point is not consistently maintained throughout the paper. Demonstrates general understanding with limited critical analysis of the research topic and thesis (argument). Summarizes perspectives, counter-arguments, or opposing positions.
0 pts
Unsatisfactory – Beginning
Fails to identify a relevant research topic or is not clearly defined and/or the paper lacks focus throughout. Demonstrates a lack of understanding and inadequate analysis of the research topic and thesis. Analysis is superficial based on opinions and preferences rather than critical analysis.
15 pts
This criterion is linked to a Learning OutcomeDecision Making and Clinical Reasoning
15 pts
Exemplary
Provides compelling and accurate evidence to support in-depth analysis to the central position beyond the required (2) research sources with at least 1 source from a periodical database. Research sources are highly relevant, accurate, recent (less than 5 years old) and reliable and add to the strength of the content.
10 pts
Accomplished
Provides essential, accurate evidence to support the central position with the required (2) research sources including 1 source from a periodical database that are mostly relevant, accurate, recent (less than 5 years old) and reliable.
5 pts
Developing
Provides some evidence to support the central position with less than 2 acceptable research sources. Some sources may not be relevant, accurate, and reliable, greater than 5 years old and may not be from scholarly sources.
0 pts
Unsatisfactory – Beginning
Lacks sufficient research sources to support the central position and/or, if included, are generally not relevant, accurate, or reliable. Contains numerous factual mistakes, omissions, or oversimplifications.
15 pts
This criterion is linked to a Learning OutcomeOrganization & Presentation
15 pts
Exemplary
Content is effectively organized. Ideas are arranged logically, flows smoothly, with a strong progression of thought from paragraph to paragraph connecting to the central position. Includes all required components (introduction, body, conclusion, citations, references, etc.). For a slide presentation, the design, font size, style, and spacing are optimal for audience viewing
10 pts
Accomplished
Content is adequately organized. Ideas are arranged reasonably with a progression of thought from paragraph to paragraph connecting to the central position. Includes required components of an introduction, body, and conclusion. For a slide presentation, one or more components of the design, font size, style, and spacing may be less than ideal for audience viewing.
5 pts
Developing
Content is somewhat organized. For a paper, occasionally ideas from paragraph to paragraph may not flow well and/or connect to the central position or be clear as a whole. May be missing a required component and/or components may be less than complete. For a slide presentation, multiple aspects of the design require further development for optimal audience viewing.
0 pts
Unsatisfactory – Beginning
Content lacks logical organization and impedes readers’ comprehension of ideas. For a paper, central position is rarely evident from paragraph to paragraph and/or the paper is missing multiple required components. For a slide presentation, the design lacks clarity for optimal viewing by an audience.
15 pts
This criterion is linked to a Learning OutcomeWriting and APA Formatting
15 pts
Exemplary
Content is well written and uses standard English characterized by elements of a strong writing style. Basically, free from grammar, punctuation, spelling, usage, or formatting errors. APA guidelines for formatting are consistently followed. Includes in-text citations and references that are written correctly.
10 pts
Accomplished
Content shows above average writing style and clarity in writing using standard English. Minor errors in grammar, punctuation, spelling, usage, and/or formatting. APA guidelines for formatting are present. In-text citations are present but may not be complete or correctly formatted. References are written using correct APA format
5 pts
Developing
Content shows an average and/or casual writing style using standard English. Some errors in spelling, grammar, punctuation, and word usage. Use of APA guidelines are generally present, however are incorrectly formatted.
0 pts
Unsatisfactory – Beginning
Content shows a below average/poor writing style lacking in elements of appropriate standard English. Frequent errors in spelling, grammar, punctuation, and word usage. Lacks elements required in writing a formal APA paper: title page, references, in-text citations, headers.
15 pts
Total Points: 60
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Requirements: No more than 15 slides
Capstone Project
Student Name
College
Course Number & Name
Instructor’s full name and credentials
Date assignment is due
Introduction
Pressure ulcers (PU) occur when the skin and the underlying tissue are damaged due to persistent pressure, primarily on the skin covering the heels, ankles, hips, and tailbone. PU mostly occurs among elderly patients due to deteriorating mobility, nutritional deficit, and physical challenges due to severe chronic diseases. These conditions make elderly patients hospitalized, wheelchair-bound, and bedridden, increasing their susceptibility to PU. Borojeny et al. (2020) demonstrate that this problem occurs during home-based care and across diverse healthcare settings like hospitals, clinics, long-term care facilities, and community health centers. As a result, various strategies have been implemented to guarantee reduced pressure on the skin of elderly persons that causes pressure ulcers.
Pressure redistributing devices, proper nutrition, skincare, and regular repositioning in elderly patients have been used to prevent the development of pressure ulcers. However, selecting a suitable intervention based on the patient’s agility, skin condition, skin exposure to pressure, staff accessibility, and weight is paramount (Collier et al., 2023). It prevents additional complications to their health conditions and boosts their welfare and quality of life. This study aims to determine the overall efficiency of incorporating pressure redistributing devices (I) in preventing the development of the condition (O) compared to using only regular repositioning (C) in six months (T) among elderly patients at high risk of pressure ulcers (P). Incorporating pressure redistributing devices with regular repositioning (I) effectively prevents the development of pressure ulcers (O) than using only regular repositioning (C) in elderly patients (P) within six months (T).
Statement of the Problem/Opportunity
Pressure ulcers is a significant health concern among the elderly population, especially the bedridden, those with chronic health conditions, nutritional problems, and the physically challenged. These conditions limit their ability to change positions, increasing skin pressure (Buh et al., 2021). High PU prevalence among the elderly across different healthcare settings and hospital wards demonstrates its severity as a health concern (Borojeny et al., 2020). It has led to high hospitalization duration, more rehospitalization cases, and slowed recovery for elderly patients, which overburden the healthcare system. Therefore, appropriate interventions are crucial to reducing the associated costs.
PU may become chronic or persist for extended periods due to inappropriate or lack of ideal management of the condition (Stanberry et al., 2022). This increases the elderly patients’ vulnerability to other health conditions. For instance, elderly patients with grade 3 and 4 PU types may develop chronic wounds on the pressure ulcer site and eventually die due to ulcer complications, such as osteomyelitis. Therefore, preventing, evaluating, treating, and managing PU requires a comprehensive and multidisciplinary strategy to identify patient needs. This involves considering the elderly patients’ underlying pathologies, nutritional deficiency, comorbidities, social and emotional support, and functionality (Borojeny et al., 2020).
Several initiatives have been developed to prevent the development of PU among elderly patients. These include skin care, pressure redistributing devices, regular positioning, and appropriate diets for the elderly. The efficiency of these methods largely depends on their capacity to cater to the patient’s needs, as none is fit for all patients (Flores-Flores & Gallo, 2022). Primarily, skin care and appropriate nutritional intervention have enhanced the other measures. Nonetheless, pressure redistributing devices and regular positioning have mostly been used individually or jointly to prevent excessive pressure on elderly patients’ skin (Stanberry et al. (2022).
Background
Pressure ulcers result from additional pressure over the body’s skin. The condition is typical among older people admitted to healthcare settings who remain immobile for a long time. According to Sardo et al. (2023), the significant causes of PU include pressure applied by the body weight, shearing forces or gliding of the skin and external surfaces, and frictional skin rubbing. These forces cause insufficient blood supply that limits the supply of oxygen and nutrients to the affected part. However, constant body movement and changing of the postures avoid extended pressure on a single part of the body.
Elderly patients are highly vulnerable to pressure ulcers due to risk factors like stress, poor nerve supply, edema, infections, poor diets, paralysis due to spinal cord damage, and long exposure to most surfaces. In addition, elderly patients without control over their bowels, those with mobility difficulties, previous pressure ulcer cases, serious illnesses due to massive surgery, major injuries, heart failure, obesity, dehydration, and chronic illnesses are highly susceptible to pressure ulcers. Such factors have increased PU prevalence among the elderly, with most having delayed recovery, making it the third most costly illness and a major cause of death. As a result, determining the common causative factors for PU among elderly patients is relevant to effective nursing care and prevents the development of the condition (Borojeny et al., 2020). Improved conditions within the healthcare units for the elderly would reduce PU incidences and enhance overall health.
Some healthcare institutions have embraced skin care practices, improved nutrition for the elderly, regular body positioning, pressure relieving, and redistributive devices to prevent PU. The efficiency of these strategies depends on the patient’s existing health condition and exposure to additional pressure. However, incorporating pressure redistributive devices and regular body positioning has proved practical (Shi et al., 2021a). Pressure redistributive devices comprise comfortable cushions, mattresses, chairs, and appropriately designed overlaps based on a patient’s needs to reduce pressure, shearing forces, and friction to uphold the patient’s welfare and comfort (Stanberry et al., 2022). At the same time, regular body positioning requires adequate healthcare staff to maintain routine monitoring and positioning of the patients.
Significance of the Project
The accumulative impacts of a weakened body due to immobility, diverse chronic diseases, and nutrition deficiency make older persons susceptible to pressure ulcers. Accordingly, preventing elderly patients from extra pressure on their skin requires an integrated approach, like incorporating pressure relieving and redistributing devices with regular body repositioning to reduce potential pressure on their skin (Collier et al., 2023). This project intends to add perceptions to the current research on the efficacy of incorporating pressure relieving and redistributing devices with regular body position to reduce PU compared to regular body positioning. This will include the cost-efficiency approach and essential considerations when including such devices within the elderly persons’ healthcare unit. Ultimately, it will highlight the benefits of integrating redistributive pressure devices and regular positioning.
Moreover, this project aims to improve practices and policies for reducing the high risk of PU for elderly patients. This entails guaranteeing healthy aging using improved and equitable healthcare practices, as WHO (2023) describes it. WHO (2023) endorses adequate healthcare preparations to convey quality care for seniors via practical and responsive initiatives. Hence, this study’s guidance on the efficiency of incorporating distributive devices alongside regular body repositioning is part of the actions toward improved care for older people. Besides, it will significantly back the WHO Global Strategy and Action Plan on Ageing and Health procedures and activities for better healthcare for seniors.
Furthermore, implementing this project’s initiative in real healthcare settings would benefit the aging population frequently admitted for various health issues. The project supports patients’ choice of healthcare facilities with appropriately incorporated redistributive pressure devices alongside adequate positioning to avoid risk factors of pressure ulcers. In line with Collier et al. (2023), comfort among elderly patients enhances their physical, social, and psychological well-being. In addition, regular positioning requires the healthcare staff supervising elderly patients to do so routinely to avoid excessive pressure on their delicate skin. Thus, integrating the two will improve the elderly patients’ overall outcomes.
Literature Review
Using appropriate interventions to reduce pressure ulcers among the elderly is paramount to improving their health (Buh et al., 2021). This has resulted in various initiatives to prevent extra pressure on the senior’s skin. However, this literature review will focus on the existing literature on the efficiency of integrating pressure redistributing devices and regular repositioning compared to reliance on body repositioning only for senior patients at great risk to PU in a given period.
Methods of Searching
A literature review was performed from manual and electronic databases. Based on the outcomes, a systematic approach followed. Important databases were Google Scholar, NCBI, CINAHL, EBSCOHost, MEDLINE, Web of Science, and PubMed. Basic and Boolem keywords and key phrases were set to enhance the search. Words incorporated included “regular repositioning,” “pressure ulcers,” “pressure redistributing devices,” “regular repositioning and pressure ulcers,” and “pressure redistributing devices and pressure ulcers” to get appropriate resources during the search. Only articles published in the last five years were considered insightful.
Review of the Literature
Gillespie et al. (2020) provided crucial insights into the cost and efficiency of repositioning approaches. The authors recommended practical repositioning plans and reducing injuries on adults due to pressure in diverse healthcare settings. The study also found no published randomized control trial research on procedural pain, patient welfare, and quality of life. In addition, the researchers concluded that there is insufficient proof of the efficiency of applying a single repositioning position over other methods to avoid pressure injuries. Thus, Gillespie et al. (2020) major insight is that the repositioning initiative’s efficiency in preventing PU over others is undefined.
Sharp et al. (2019) demonstrated that despite regular repositioning of some elderly patients at risk of developing PU, some succumb to the condition. In particular, the authors demonstrated that a two-hourly repositioning could not avert the development of PU in approximately one-third of the participating elderly residents. Furthermore, the study explained that the two-hourly repositioning might violate the patient’s rights. As a result, Sharp et al. (2019) concluded that giving patients alternating-pressure air mattresses may become more sensible. This way, the study confirms that incorporating regular positioning and redistributive devices is more efficient than only repositioning the patient.
Nixon et al. (2019) gave crucial insights based on a study where subjects were exposed to interventions such as alternating pressure mattresses and high-specification foam for sixty days. The study found limited evidence of the difference in time for the development of PU after a 30-day follow-up. The alternating pressure mattresses had minimal benefit. Consequently, Nixon et al. (2019) recommended using alternating-pressure mattresses in suitable cases. This means that the initiative should target the elderly patient’s choices, comfort, and therapy needs and the existence of modifiable risk aspects. Besides, the study’s findings demonstrate that using pressure redistributive devices only is insufficient to prevent the development of PU among elderly patients.
Shi et al. (2021b) sought to evaluate the comparative advantages of different pressure redistributive devices such as mattresses, beds, and overlays. The study demonstrates that Static air mattresses and overlays, gel pads, and alternating pressure air mattresses might be highly efficient than foam mattresses in averting the development of PU. In line with the study, alternating pressure air mattresses’ health merits surpass their costs in reducing PU than foam mattresses. However, using static air mattresses is highly effective but costly. The authors also demonstrate that reactive air surfaces allow for better healing of PU than foam surfaces.
On the other hand, Shi et al. (2021a) showed that active air-filled surfaces are more likely to lower the risk of developing PU than foam surfaces. However, for persons who underwent surgery, using a gel surface during the operation and a foam surface on their hospital beds remained less practical in preventing PU over the active air-filled surfaces. Likewise, the authors found that active, air-filled surfaces may escalate the risk of PU than reactive air surfaces. Hence, this study suggested that the efficiency of the pressure relieving and redistributive devices depends on the patient’s need. It also indicates the need to incorporate pressure redistributive devices with regular repositioning to boost their applicability.
Findings
Gillespie et al. (2020) demonstrate the uncertainty of the efficiency of using regular repositioning only to prevent the development of PU among elderly patients. Nonetheless, using pressure redistributing devices is highly practical in averting PU development (Shi et al., 2021a; Nixon et al., 2019). Still, the efficiency of pressure redistributive devices depends on the patient’s need, with some being more practical than others (Shi et al., 2021a). Sharp et al. (2019) proved that alternative pressure air mattresses are superior to consistent body repositioning. Hence, assessing patients’ needs before recommending any initiative to reduce their risk of PU is necessary.
Some pressure redistributive devices are more efficient than others. For example, static air mattresses, gel pads, and alternating air mattresses are more effective in preventing the development of PU than foam mattresses (Shi et al., 2021b). Nevertheless, the authors proved that active, air-filled surfaces are cost-effective in minimizing risk to PU. Although expensive, reactive air surfaces are superior in preventing PU development (Shi et al., 2021b). Such findings are mostly based on a meta-analysis that reveals major gaps in studies demonstrating the use of pressure redistributive devices and regular repositioning of patients. Hence, further primary randomized control trial is needed to explain the situation.
Outcomes, Approach, and Budget
This project aims at reducing the elderly patient’s risk of developing PU through the effective incorporation of pressure relieving and redistributing devices to the routine repositioning of the patients. This can boost the patient’s recovery and prevent unnecessary hospitalization, rehospitalization, and associated costs. A strategic approach is required to implement the plan to allow a reasonable budget, as discussed in the subsequent sections.
Outcomes
The anticipated outcomes of this project are the sufficient acquisition of pressure redistributive devices for the diverse elderly patients’ needs, less pressure on their skin, and reduced or no cases of PU. The outcomes should be;
S: Specific – This means the outcomes will be specific for quality care improvement, as Waldrop and Reynolds (2023) guide—for instance, adequate redistributive devices to minimize PU cases for elderly patients effectively.
M: Measurable – It implies the outcomes are quantifiable. For instance, the number of reduced PU cases in the elderly patient unit.
A: Achievable – This shows manageable outcomes like sufficient incorporation of redistributive devices and regular repositioning initiatives for elderly patients at risk of PU due to adequate monetary resources.
R: Realistic – The outcomes are reasonable to improve health. In this case, preventing the development of PU among elderly patients is critical for their quality of health.
T: Time-bound – The results are attained during the specified duration, six months.
Approach
In line with Yoo et al. (2019), addressing the outcomes includes communicating to the stakeholders whether the project’s evidenced-based initiative achieved the anticipated results. Therefore, this will involve discussions concerning the outcomes to determine their feasibility based on each milestone. Evaluating the program’s outcomes based on schedule is also critical to determining the timeliness. Besides, revisiting the human and financial resources involved will be critical to addressing the cost efficiency of the scheme based on its impacts, as Moran et al. (2023) outline. These actions will guide on the appropriate means to boost the outcomes.
Effective communication will sustain collaborative efforts on the project’s deliverables to create improved project outcomes. Besides, regularly monitoring the project’s progress will enhance transparency. Likewise, ensuring adequate nursing staff to reposition the patient will boost the anticipated patient’s health. Additionally, regular use of patient feedback will determine improvement areas, as Waldrop and Reynolds (2023) guide. Finally, action on the areas requiring improvement would guarantee improved and consistent outcomes.
Budget
About $14.5 million (Table 1) will be used to execute the project. The budget caters to the costs of buying various pressure relieving and redistributing devices, modifying the elderly patient’s unit, and the payments for the project’s team and extra staff for cleaning and constant monitoring of the practical usage of the devices. It also includes staff training expenses to guarantee the appropriate use of redistributive devices alongside normal repositioning. Finally, repair and maintenance costs are included to allow consistency of the project’s initiative. Community-based firms, part of the hospital’s returns, and the state, local, and federal healthcare funds will contribute to the plan’s funding.
Table 1: Total budget for project requirements.
Strategies and Results
A project towards effectively implementing pressure redistributing devices to the normal repositioning of elderly patients requires well-outlined strategies. This includes evaluating the risks and threats and using available strengths and opportunities to achieve anticipated results. However, collaborative approaches and ethical considerations are necessary to reinforce the outcomes.
Strategies
The suggested action plan is to purchase pressure redistributing devices for aging patients based on their needs and vulnerability to PU, as Shi et al., 2021) guide. This will reinforce the effects of regular repositioning of the patients in preventing the development of PU. Advantages of the plan include a high reduction of PU cases, improved recovery, low hospitalization duration, and less rehospitalization for elderly patients (Sardo et al., 2023; Nixon et al., 2019). However, the execution of the project is expensive, as indicated in the budget. Purchasing all the devices based on the patient’s needs is expensive.
The project has risks and ethical concerns involved. Exceeding the budget is a significant risk for this project, which Kiss et al. (2023) demonstrate occurs due to unexpected or underestimated costs. Other risks include inadequate staff training and resistance to change by the staff and the patients. This may lead to ethical problems, such as not considering patient autonomy, as (Pugh, 2020) indicate. In addition, it may lead to unauthorized use of patients’ sensitive health records and inequitable access to pressure redistributing devices for senior patients if anonymity and social determinants of health are not considered, respectively. Hence, informed consent, affordable access to the newly modified units, and well-maintained patient privacy and confidentiality are crucial for successfully implementing the project.
Results
The anticipated improvement to the suggested outcome is efficient knowledge among the staff on the appropriate use and maintenance of pressure redistributive devices. In addition, the patient’s skin condition and the risk of developing PU should be constantly assessed. Still, constant repositioning of the patient, nutritional support, and skin care would enhance an inclusive preventive approach, as Flores-Flores and Gallo (2022) reveal. Both qualitative and quantitative data will be compared to gauge the anticipated impacts. Quantitative statistics will involve the frequency of PU before and after the plan’s implementation through medical records and constant assessments, as Sardo et al. (2023) demonstrate. This will also show the number of bought redistributive devices and their effective usage. However, qualitative data will be obtained through patients’ feedback on the device’s impact on comfort, well-being, and overall health.
Formative evaluation will be crucial to assess the process’s direct output. This will illustrate the project’s achievements, such as reduced PU cases among the elderly within the hospital, adequate staff knowledge on effective use of pressure redistributive devices, and the patient’s willingness to embrace the changes. Furthermore, formative evaluation will determine if the outputs were achieved based on the timeline. Clarke et al. (2019) state these evaluation outcomes are crucial to enhancing the intervention. On the other hand, summative evaluation will determine the project’s short-term and long-term consequences. Short-term changes include the patient’s and staff’s acceptance, awareness, and attitude toward improved behavior, attitude, and awareness. Long-term effects will be assessed based on the project’s impacts on reduced hospitalization, rehospitalization, and deaths among senior patients due to PU. Besides, summative evaluation will determine the plan’s impact on society and healthcare systems, such as reduced burden to costs involved, as Clarke et al. (2019) demonstrate.
Conclusion
Incorporating pressure redistributing devices averts the development of PU among elderly patients than using only regular repositioning initiatives. Nonetheless, this necessitates a suitable choice of ideal devices based on a patient’s need (Nixon et al., 2019). This includes the patient’s health, weight, mobility, and skin condition. These considerations avoid potential risk factors for the development of PU among elderly patients despite using pressure-redistributive devices. Besides, this shuns likely complications of potential health challenges while boosting the quality of older persons’ life, as WHO (2023) recommends.
Based on the literature review, some pressure redistributing devices are highly effective than others or other initiatives. For instance, Sharp et al. (2019) demonstrate that gel pads and alternating pressure air mattresses are highly effective than two-hourly repositioning of the patients. Likewise, Gillespie et al. (2020) demonstrate that regular repositioning alone cannot minimize the risks of developing PU. Shi et al. (2021b) also indicate that using alternating pressure air mattresses’ health merits surpass their costs in reducing PU than foam mattresses. However, the study showed that using static air mattresses is highly effective but costly. Hence, the need to implement cost-effective strategies to reduce PU among senior patients.
Overall, incorporating pressure relieving and redistributing devices with regular repositioning (I) for elderly patients at risk of pressure ulcers (P) efficiently lessens the development of the condition (O) than using body repositioning only (C) within a shorter period, such as six months (T). Nevertheless, the strategy involved should consider specific risks like the possibility of exceeding the allocated budget, staff and patient resistance towards the novel changes, and limited knowledge on appropriate maintenance and use of the pressure redistributing devices. Besides, patient education, providing informed consent, and maintaining patients’ anonymity during data collection would maintain their autonomy, confidentiality, and privacy. Additionally, considering the social determinants of health would allow approaches to ensure equitable healthcare access. This way, the project’s anticipated results will be achieved.
References
Borojeny, L. A., Albatineh, A. N., Dehkordi, A. H., & Gheshlagh, R. G. (2020). The incidence of pressure ulcers and its associations in different wards of the hospital: a systematic review and meta-analysis. International Journal of Preventive Medicine, 11.
Buh, A. W., Mahmoud, H., Chen, W., McInnes, M. D., & Fergusson, D. A. (2021). Protocol: Effects of implementing Pressure Ulcer Prevention Practice Guidelines (PUPPG) in the prevention of pressure ulcers among hospitalised elderly patients: a systematic review protocol. BMJ Open, 11(3).
Clarke, G. M., Conti, S., Wolters, A. T., & Steventon, A. (2019). Evaluating the impact of healthcare interventions using routine data. bmj, 365.
Collier, M., Jones, S., & Glendewar, G. (2023). Pressure ulcer prevention, patient positioning and protective equipment. British Journal of Nursing, 32(3), 108-116.
Flores-Flores, O., & Gallo, J. J. (2022). One size does not fit all. The American Journal of Geriatric Psychiatry, 30(7), 848-849.
Gillespie, B. M., Walker, R. M., Latimer, S. L., Thalib, L., Whitty, J. A., McInnes, E., & Chaboyer, W. P. (2020). Repositioning for pressure injury prevention in adults. Cochrane Database of Systematic Reviews, 1(6), 1-10.
Kiss, A., Kiss, N., & Váradi, B. (2023). Do budget constraints limit access to health care? Evidence from PCI treatments in Hungary. International Journal of Health Economics and Management, 23(2), 281-302.
Moran, K. J., Burson, R., & Conrad, D. (2023). The doctor of nursing practice project: A framework for success. Jones & Bartlett Learning.
Nixon, J., Smith, I. L., Brown, S., McGinnis, E., Vargas-Palacios, A., Nelson, E. A., … & Hulme, C. (2019). Pressure relieving support surfaces for pressure ulcer prevention (PRESSURE 2): clinical and health economic results of a randomized controlled trial. EClinicalMedicine, 14, 42-52.
Pugh, J. (2020). Autonomy, rationality, and contemporary bioethics. Oxford University Press.
Sardo, P. M. G., Teixeira, J. P. F., Machado, A. M. S. F., Oliveira, B. F., & Alves, I. M. (2023). A systematic review of prevalence and incidence of pressure ulcers/injuries in hospital emergency services. Journal of Tissue Viability, 32(2), 179-187.
Sharp, C. A., Schulz Moore, J. S., & McLaws, M. L. (2019). Two-hourly repositioning for prevention of pressure ulcers in the elderly: patient safety or elder abuse?. Journal of bioethical inquiry, 16, 17-34.
Shi, C., Dumville, J. C., Cullum, N., Rhodes, S., Jammali-Blasi, A., & McInnes, E. (2021b). Alternating pressure (active) air surfaces for preventing pressure ulcers. The Cochrane Database of Systematic Reviews, 2021(5), CD013620.
Shi, C., Dumville, J. C., Cullum, N., Rhodes, S., McInnes, E., Goh, E. L., & Norman, G. (2021a). Beds, overlays and mattresses for preventing and treating pressure ulcers: an overview of Cochrane Reviews and network meta‐analysis. Cochrane Database of Systematic Reviews, 1(8), 1-10.
Stanberry, B., Lahti, N., Kevin, C., & Delin, J. (2022). Preventing pressure ulcers in emergency departments: four simple and effective nurse-led changes. Emergency Nurse, 30(5).
Waldrop, J., & Reynolds, S. (2023). Curricular revision to increase use of quality improvement principles in doctor of nursing practice projects. The Journal for Nurse Practitioners, 19(3), 104530.
World Health Organization (WHO) (2023). Addressing the needs of ageing populations (who.int).
Yoo, J. Y., Kim, J. H., Kim, J. S., Kim, H. L., & Ki, J. S. (2019). Clinical nurses’ beliefs, knowledge, organizational readiness and level of implementation of evidence-based practice: The first step to creating an evidence-based practice culture. PloS one, 14(12), e0226742
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