Project, transition and planning

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Please refer this project to the attached problem which is a presentation.

The Problem is about pressure ulcer.

Note: APA format, 3-4 references

In this assessment, you will work through the planning and implementation stages of the project. This will require you to determine goals and resources needed and to select an evidence-based practice (EBP) model.

Part 1 – Literature Review

Research best practices to identify an effective intervention for your selected problem. Your goal is to gather evidence from scholarly literature to support the most effective intervention strategy.

The performance appraisal tools in this week’s learning activities will help you determine appropriate scholarly sources of evidence to cite.

Locate at least 3 original research articles that support your proposed solution to your selected problem.

  • The articles must be peer-reviewed, published within the past 5 years, and statistically significant.

To begin, write a 350-word summary of each article in which you:

  • Identify current guidelines or best practices relating to your proposed solution, or if there are protocols, the current standard of care.
  • Define your proposed intervention(s) to address the problem.
  • Explain how the intervention will result in a solution to the problem

Continue to Week 4 to complete Part 2 of the summative assessment and submit both parts at the end of Week 4.

Healthcare Problem Presentation

By: Vannelyn Oriel


Problem Definition

In this case, pressure ulcers is the problem that was identified.

Pressure ulcers refer to injuries to the skin and underlying tissue and this is can be attributed to prolonged pressure on the skin.

Today, pressure ulcers is increasingly becoming a major health concern globally.

Healthcare systems worldwide continue to direct resources towards helping patients effectively and efficiently manage pressure ulcers.

Pressure ulcers is becoming a major health concern globally.

It root cause is prolonged pressure on the skin.

It mostly affects patients in hospitals.

Few studies have focused on assessing this healthcare problem.

It is a pattern that I would like to change to improve quality.


Pressure Ulcers

According to data from the Agency for Healthcare Research and Quality (AHRQ), more than 2.5 million people in the U.S. develop pressure ulcers annually.

Pressure ulcers especially among patients recovering in hospitals bring pain.

The healthcare problem also leads to increased health care utilization.

There is increase risk for serious infection among patients in hospitals.

Overall, documented cases of pressure ulcers has been on an upward trend globally.

In most cases, pressure ulcers develop among patients who have a specific health condition that limits their ability to change positions.


Symptoms and Causes of Pressure Ulcers

There exist various symptoms and causes of pressure ulcers.

The first symptom is unusual changes in a patient’s skin color or texture.

Increased tenderness of skin areas.

Swelling can be observed.

Pus-like draining is another symptom.

Bedsores can be categorized into different stages that cause pressure ulcers.

Common areas for pressure ulcers


Back of legs, and arms where a patient rests against the chair.

Shoulder and spine.


Risk Factors

Immobility for example, assuming a patient in hospital is using a wheelchair, they would apply pressure to specific parts such as buttocks leading to pressure ulcers.

Incontinence where a patient’s skin becomes susceptible due to extended exposure to urine and stool.

Poor diet and nutrition leading to lack of vitamins and minerals that can lead to a healthy skin.

Patients with diabetes also have high risk of experiencing pressure ulcers.

Pressure ulcers if not well managed and treated among patients can lead to complications such as cancer, and bone and joint infections.


Description of the Problem

Pressure ulcers is a major health concern in today’s nursing practice.

Despite so, it is largely preventable in nature.

The management of pressure ulcers relies on its severity.

A study by Surg, 2015 established that cleaning of wound, using antibiotics, and undergoing reconstructive surgery were the present treatment options for pressure ulcers (Surg, 2015).

However, there exist newer treatment options such as cell therapy, wound therapy and wound therapy.

Nurses have a vital role to play in prevention and management of pressure ulcers among patients.

It has today become a patient safety issue.

For this reason, effective preventive and management strategies signifies a marker of quality of care that should be leveraged by nurses.


What could happen if the problem is not addressed

As a nurse, if the problem of pressure ulcers among patients in hospitals is not effectively addressed, then the consequences can be unimaginable.

First, it can lead to a significant damage of tissues on a patient’s body and they may eventually die.

Most often, pressure ulcers do not lead to death.

However, it can lead to a decline in health of an individual.

Treatment of pressure ulcers can be costly thus negatively impacting on the economic well-being of patients and their families.

Consequences of pressure ulcers can be significant for example, severe skin damage, reduced body immunity, increased cost of treatment and even death if not well-managed.


Relevance of the problem

It is important for individuals especially those in nursing career to be aware and know more about pressure ulcers.

A research anchored on knowledge and practice of nurses towards prevention of pressure ulcer found it to be inadequate among them (Nuru et al., 2015).

It presents a huge challenge as many nurses lack knowledge and practice of effectively and efficiently preventing and managing pressure ulcers.

Understanding pressure ulcers will help in determining how it impacts an patient’s well-being in hospital.

It is important to appreciate the fact that there is a huge gap in terms of knowledge and practice regarding pressure ulcers among nurses globally.

For this reason, there is need for an intervention towards equipping nurses with the requisite support systems to help them effectively prevent and manage pressure ulcers.

Eventually, this will lead to desirable health outcomes among patients.


A real-life scenario of Pressure Ulcers Knowledge and Practice among Nurses

To effectively describe the problem, there was need to create a real-life scenario of pressure ulcers.

The figure show’s nurses knowledge and practice concerning how to prevent pressure ulcers at Gondar University Hospital, Northwest Ethiopia (Nuru et al., 2015).

Ways of reducing knowledge and experience gap in Pressure Ulcer among Nurses.

Boosting nursing in-service training anchored on pressure ulcers.

Providing requisite facilities and equipment to effectively prevent and manage pressure ulcers among patients.

Upgrading nursing courses.


Proposal to address the problem

As pressure ulcer continues to become a major health concern globally, there is need to develop requisite prevention and management plans aimed at enhancing patient care.

It is vital to appreciate the fact that despite massive efforts towards managing and preventing pressure ulcers, the complexity of the problem continues to increase.

For this reason, there is need to develop an effective and efficient strategies of addressing the problem of pressure ulcers.

Addressing the problem of pressure ulcer is becoming complex.

As a result, clinicians, nurses and patients experience significant challenges in quest to achieving high-quality healthcare.

Factors that have made addressing the issue of pressure ulcers difficult.

Difficulties in categorizing pressure ulcers into levels.

Poor inter-agency working and relations.

Poor morale of nurses.


Addressing the problem of pressure ulcers

First, there is need for increased inter-agency working between nurses and other medical professionals such as surgeons, clinicians, and pharmacists,

Inter-agency collaboration will lead to formation of teams that will tackle pressure ulcers in hospitals and achieve desirable patient outcomes in the long run.

It also closes communication gaps and this will enable nurses and other professions in health care share ideas concerning treatment of patients with pressure ulcers.

Inter-agency working in healthcare has been given a wide berth.

Nurses ought to incorporate it in their practice to boost knowledge and experience.

Eventually, they will deliver high-quality care to patients with pressure ulcers.


Addressing the problem of pressure ulcers

Nurses have a vital role to play in increasing awareness among patients at a hospital concerning risk of pressure ulcers.

For example, nurses can advise patients at a hospital to minimize time that thy apply pressure on their skin.

Consequently, this will help in improving skin quality thus improved health of the patient in the long run.

It is important that nurses maximize on using pressure injury monitoring devices.

It will help in assessing various aspects of skin such as moisture, body motion.

Pressure-sensing mats can be placed on patients wheel-chair to monitor pressure applied thus preventing potential of sores.


Addressing the problem of pressure ulcers

Nurses can play an integral part in developing a plan to help the caregiver of a patient follow when taking care of the patient at hospital.

The care plan can also integrate various aspects such as position changes, good diet and lifestyle changes.

Undertaking routine nursing assessment of patients at hospital can help identify the problem in good time.

Early detection of pressure ulcers can help mitigate its effects on a patient in the long run.

Factors that lead to improved health of pressure ulcer patients.

Position changes,

Good diet

Lifestyle changes


Addressing the problem of pressure ulcers

Apart from management and prevention as ways of addressing pressure ulcers, nurses can incorporate treatment as a way of enhancing high-quality patient care.

Through surgery, a patient with pressure ulcer can be treated.

Surgery helps to seal the wound and bring about healing.

Surgery also reduces the risk of infection among patients in hospitals as wounds would be completely sealed.

The biggest impediment to surgery as a way of treating pressure ulcers is that it does not suit people who are already in poor state of health.


Addressing the problem of pressure ulcers

When addressing the issue of pressure ulcers, it is essential to consider different groups of people who are at high-risk of getting pressure ulcers.

Adult people who are older than 70 years old have high probability of being infected with pressure ulcers due to mobility problems associated with this age.

People with obesity also have high likelihood of getting pressure ulcer.

Individuals who practice a poor diet also have high probability of getting pressure ulcers.

Nurses ought to consider various aspects when handling patients with pressure ulcers.

Central to improved patient care is accelerating awareness and education on this health problem.


Identification and Discussion of Ethical, legal and Regulatory Concerns relating to Pressure Ulcers

Concerning ethical concerns, nurses who undertake research in pressure ulcers have to deal with confidentiality, ethical dilemmas attributed to conflict between transparency and responsibility to the patients and the requirements for research and informed consent.

Additionally, five ethical theories that is utilitarianism, virtue ethics, deontology, egoism and care ethics form the basis of ethical aspects of nursing.

For example, under egoism as an ethical aspect, a nurse is required not to overwork but at the same time promote self-care among patients.

Understanding ethical aspects impacting pressure ulcers is complex.

Five theories provide anchorage to the ethical aspects of pressure ulcers.


Virtue ethics



Care ethics


Ethical Issues

Ethical aspects of deontology and utilitarianism provide a framework where the pressure ulcer patient can access all relevant information to help in achieving best health outcomes in the long run.

A nurse ought to inform a patient with pressure ulcers of their condition and its implications.

Care ethics provides for delivery of patient-focused and focused treatment plans of patients with pressure ulcers.

Nurses need to consider ethical aspects aimed at providing high-quality care to patients with pressure ulcer.

Doing so will enable them avoid doing the wrong thing thus enhancing their professionalism.

Training and coaching on ethical aspects can be crucial to providing patient-focused care to patients with pressure ulcers.


The Legal and Regulatory Aspect of Pressure Ulcers

Today, lawsuits associated with patients with pressure ulcers are common and continue to increase globally.

Under the legal aspect, assuming a patient develops pressure ulcer and that there is documentation where a doctor had been notified, in this case there will be no treatment since the physician would not have intervened (Fife, 2020).

Consequently, this can lead to serious health problems for patients with pressure ulcers.

It can then be classified as breach of duty and low-quality care therefore, negligence (Lockhart & Goudberg, 2002).

An nurse or any healthcare professional can be sued.

A nurse ought to avoid litigation by providing high standard of care to the patient with pressure ulcers.

Legal aspects surrounding pressure ulcers vary from country to country.

Individual countries design laws in way that suits them.

However, one thing that cuts across regarding legal aspect is that in leverages on making health care professionals deliver high-quality care.


Explanation of why I chose the problem

First, pressure ulcers is increasingly becoming a major health concern globally thus the reason why I chose it.

The problem was interesting to me as there exist few studies that have be done on it.

Additionally, the impact of pressure ulcers tend to be underestimated by many people yet they seriously impact a patient’s health.

I wanted to explore this problem to determine how it has impacted nursing as a career based on knowledge and experience.

Pressure ulcers is underestimated.

It can be deadly if not detected early.

There exist mechanisms through which nurses can improve care of patients with pressure ulcers.

Little research has been done anchored on pressure ulcers.


Why I chose the topic

Many hospitals especially those in developing nations have nurses who have little knowledge and experience concerning pressure ulcers

This was an insightful finding for me.

Pressure ulcers is a complex condition based on prevention and management thus many people shy away from examining it.

I wanted to explore a problem that has not received the required attention

Pressure ulcers hugely impacts the global health system yet many people ignore it.;

Pressure ulcers as a problem has been neglected.

Need for increased on research anchored on pressure ulcers.

Inter-agency collaboration needed to boost quality of care given to patients with pressure ulcers.



Lastly, pressure ulcers continues to evolves based on prevention, treatment and management among patients.

Nurses need to be considerate of the ethical, and legal aspects surrounding pressure ulcers to help their patients achieve high quality care.

There is need for increased funding on research anchored on pressure ulcers to aid in developing robust and efficient interventions that will boost patient’s health in the long.

Eventually, nurses will be motivated and inspired to provide high-quality care.

Future studies need to focus on how nurses knowledge and experience on pressure ulcers can be improved to achieved a patient-centered care in the long run.



Berlowitz. (2022). Preventing pressure ulcers in hospitals. Agency for Healthcare Research and Quality.

Fife. (2020). A Closer Look at the Legal Implications of Pressure Injuries. Todays World Clinic.

Lockhart, D. G. (2002). The legal implications of pressure ulcers in acute care. Critical Care Nursing Quarterly, 25(1), 63-68.

Nuru, Zewdu, Amsalu, & Mehretie. (2015, May 16). Knowledge and practice of nurses towards prevention of pressure ulcer and associated factors in Gondar University hospital, northwest Ethiopia. BioMed Central.

Surg. (2015, January). Pressure ulcers: Current understanding and newer modalities of treatment. PubMed Central (PMC).

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