NR 584NP Week 7 Assignment_Applying Quality Improvement (QI) to Clinical Practice - Hospital Acquired Pressure Ulcers (HAPUs)

● What inconsistencies exist between your facility’s current policies, actual nursing practice, and best evidence related to your assigned topic? What evidence (data, observation, incident reports) suggests a need for improvement? Current policy mandates that two nurses complete a patient skin check to ensure proper documentation of any potential ulcers especially on admission. This helps to determine whether the patient came to the hospital with a pressure ulcer or acquired one during the hospitalization. The two RN skin checks are reliable but when dealing with assessments of wounds, there can be inconsistencies as each nurse may assess, document, and treat wounds differently. Evidence suggests that interventions to prevent pressure injuries should be implemented immediately for patients at moderate to high risk and that staff need to be educated on proper wound assessment, documentation, and appropriate pressure injury interventions (Roderman et al., 2024). Standardizing wound assessments and documentation of pressure ulcers can help reduce variation across care and improve patient outcomes. Section 2: Analyze ● Review national safety resources related to your topic. Name at least two national organizations or initiatives (e.g., Centers for Medicare & Medicaid Services (CMS), Agency for Healthcare Research and Quality (AHRQ), Centers for Disease Control and Prevention (CDC), Institute for Health (IHI), National Patient Safety Goals (NPSG)) and summarize the guidance they provide related to your topic. The Agency for Health Care Research and Quality (AHRQ) and the Center for Medicare and Medicaid Services (CMS) provide guidance on Hospital-Acquired Pressure Ulcers (HAPUs). More than 2.5 million people in the U.S. develop pressure ulcers every year, because of this the AHRQ has developed a pressure injury prevention toolkit. This toolkit is used by hospitals across the U.S. as it guides hospitals on planning and implementing a pressure ulcer prevention program, it details evidence-based practices in prevention care for ulcers, and it provides essentials for staff such as checklists and strategies to utilize in prevention (AHRQ, n.d.). This toolkit aids hospital organizations in implementing systemic changes to improve pressure ulcer prevention and treatment to lead to better patient outcomes and reduce associated hospital costs of pressure injury development. Another organization that provides guidance on HAPUs is CMS. CMS plays an important role in HAPU prevention as CMS classifies these ulcers as Hospital-Acquired Conditions and ties reimbursement to performance in reducing hospital-acquired conditions, so any condition such as a stage 3 or stage 4 pressure ulcer that was not present on admission, the hospital organization will not be reimbursed for the care of that ulcer (CMS, 2024). If hospitals have high numbers of pressure ulcers, they may be faced with medicare payment reductions, leading to hospitals having a significant financial incentive to prevent these conditions. Section 4: Act ● Which stakeholders need to be involved in implementing this change? For this proposed policy change the stakeholders that need to be involved include nursing leadership, nurses, wound care team, quality improvement team, nurse educators, IT department, and hospital administration. Nursing leadership such as nurse managers will help to implement the