Peer response

Respond to at least two peer posts. Aimee post The nursing problem I am addressing in my project is the low skin risk assessment nursing compliance rate in the 3E Tele unit to prevent hospital-acquired pressure injuries (HAPIs). Challenges that contributed to the increased HAPIs include missed skin assessments, documentation opportunities, delayed wound care nurse consultation, and missed follow-through interventions for patients with high-risk pressure injuries. A good start to prevent pressure injury on a patient is to assess the patients risks for developing pressure injuries. My goal is to provide 3E Tele unit nursing staff with pressure injury prevention refresher educational sessions during huddles by week 4, focusing on evidence-based skin risk assessments on admission and at least once every shift change to increase the unit’s skin risk assessment compliance. The brief refresher educational refreshers will include policy adherence to skin assessment documentation and timely interventions to prevent and/or manage pressure injuries. My desired short-term outcome is to see an increase in the overall skin risk assessment compliance in the 3E Tele unit (both on admission and shift change) to 95% from an average of 93% during the past 5 months by week 7. My desired long-term outcome is to see an increase in the overall skin risk assessment compliance in the 3E Tele unit (both on admission and shift change) to 98% within 6 months. Input from the unit manager, nutritionist, and wound care specialist helped in the development of the educational flyer presented at the unit morning huddle. Another huddle presentation has been scheduled to ensure 98% or more of the nursing staff are captured. The Associate Chief Nursing Officer (ACNO) recommended that the educational flyer be posted on the nursing unit staff board to provide at-a-glance access to an ongoing reminder to complete accurate skin risk assessments and provide follow-up interventions. This will influence my short-term goal of 95% skin risk assessment compliance by week 7. By encouraging the unit manager to frequently remind and encourage staff to complete patient skin risk assessments, monitor compliance rates in the Nursing Insights dashboard, and work closely with wound care specialists and nutritionists to identify gaps and opportunities in completing and documenting accurate skin assessments, the long-term goal of 98% compliance rate can be achieved. According to Mitchell (2022), skin assessment should be part of a holistic approach because the skin is like a window to a patient’s overall health status. Skin risk assessments involve assessing a patient’s sensory perception, activity and mobility, nutritional status, and environmental risks posing threats to skin alterations. As skin risk assessments become an important part of the nurses’ routine, culturally competent care needs to be taken into consideration, such as providing culturally appropriate nutrition interventions (Munoz and Litchford, 2024). A barrier I have encountered with project implementation is the challenge of capturing all nursing staff to attend the educational huddles. The best approach the nursing manager shared was to conduct a total of two Monday morning huddles to capture both the alternate night and day shift staff, as they are scheduled on an every-other-weekend shift. With a short timeframe dedicated to this project, this became a challenge, but nonetheless, doable. A potential barrier is the lack of staff engagement to perform these skin risk assessments. An example shared was that upon chart spot-checks, interventions checked off on a checklist were not noted as performed in the flowsheet. Validating that these assessments and follow-up interventions were done and accurately performed is a challenge. A strategy to overcome this barrier would be to improve staff engagement. According to George and Massey (2020), in order to improve staff engagement, it is important to help nursing staff recognize that they play key roles in the organizational initiatives. This is where nurse leadership can use a collaborative approach to involve nurse leaders and nursing staff in shared teamwork decision-making. References George, V, & Massey, L. (2020). Proactive strategy to improve staff engagement. Nurse Leader, 18(6), 532-535. )30218-4/fulltext Links to an external site. Michell, A. (2022). Skin assessment in adults. British Journal of Nursing, 31(5). Links to an external site. Munoz, N., & Litchford, M. (2024). Wound care at the intersection of race, ethnicity, and malnutrition. Advances in Skin & Wound Care, 37(10), 536-543. Natalie post My small-scale change project focuses on preventing pneumonia in trauma patients with limited mobility on the trauma unit. The short-term goal of the project is to increase consistent use of evidence-based pneumonia prevention interventions, including incentive spirometry, early mobility as tolerated, upright positioning, and oral care (Dhillon et al., 2023). The short-term outcome is improved staff compliance with these interventions and increased patient participation. The long-term outcome is a reduction in hospital-acquired pneumonia rates, improved patient outcomes, and decreased length of stay. Several members of the interdisciplinary healthcare team have influenced progress toward my project goals and outcomes. Trauma physicians and advanced practice providers support early mobility orders and respiratory interventions, which directly impact short-term and long-term outcomes. Respiratory therapists play a key role in educating patients on proper incentive spirometry use and reinforcing lung expansion strategies. Physical and occupational therapists influence early mobilization efforts, especially for patients with severe injuries. Collaboration with nursing staff has been essential for reinforcing education, monitoring compliance, and integrating these practices into daily care routines. Achieving both the short- and long-term outcomes of this project supports holistic and culturally competent care by addressing physical, educational, and psychosocial needs. Education on pneumonia prevention can be adapted to patients cultural beliefs, language needs, and health literacy levels, promoting understanding and engagement for both patients and families. Preventing pneumonia also reduces complications that disproportionately affect vulnerable populations, supporting equitable and patient-centered care across diverse trauma populations. A primary barrier encountered with project implementation is inconsistent staff adherence due to workload, time constraints, and competing priorities in a high-acuity trauma setting. A potential barrier is limited patient participation related to pain, fatigue, or lack of understanding. An evidence-based strategy to overcome these barriers includes ongoing staff education, visual reminders, and interdisciplinary reinforcement during rounds. Utilizing brief teach-back methods and incorporating pneumonia prevention into standard care checklists can help improve consistency and sustainability of the intervention. Reference Dhillon, G., Buddhavarapu, V. S., Grewal, H., Munjal, R., Verma, R. K., Surani, S., & Kashyap, R. (2023). Evidence-based Practice Interventions for Reducing Postoperative Pulmonary Complications: A Narrative Review. The open respiratory medicine journal, 17, e18743064271499.