In the current US healthcare setting, reports have revealed that once a person is diagnosed with a particular disease, he/she runs high chances of contracting some opportunistic diseases owing to the debilitating immunity. And one reported secondary disease that has been at the peak of the news headlines is the pressure ulcers. Pressure ulcers which are defined as; sort of injuries that cause a breakdown of the skin and the underlying tissues, is said to be due to some factors including; moisture, pressure, and friction (Lahman &Kottner, 2011). It starts with the affected part of the skin leading to the integration of the entire skin. (Bhattacharya & Mishra)
According to Bhattacharya & Mishra 2015, they say that different organizations have reported that the disease is preventable. Therefore, organizations such as acute care settings have got keen interest in digging deep into the incidences of pressure ulcers in the hospitals. Now, this paper is going to reflect on how selected DNP acquired through the implementation of capstone project are competent.
Pressure ulcer prevention in a debilitated patient is my problem and hence my main point of focus. Pressure ulcers are injuries that cause breakdown of the skin and the underlying tissue. They result when an area of the skin is subjected to pressure, friction moisture at the affected area then leads to impaired skin integrity. The ulcers are also referred to as pressure sores or bed sores (Jaul, 2013). The intensity of the ulcers can vary, ranging from patches of discolored skin to severe wounds that are open exposing the underlying muscle or bone. Pressure ulcers can happen in two conditions. Firstly, the condition can develop when large amounts of pressure are applied to an area of the skin over short time periods. Secondly, the situation can occur when fewer amounts of pressure are applied to the same surface section over extended periods of time (Reddy, 2010). Reports also state that the patients who are vulnerable to pressure ulcers are the elderly, who are weak and always hospitalized because the disease is mostly hospital-acquired.
Statistics from the National Quality Forum reveals in their different analysis conducted between 1993 and 2006, shows that the disease has risen with higher percentages (Harrison & Meyer, 2011). Due to the increasing numbers in the menace, has to bring to concern on preventive ways that can be used to reduce the incidences of pressure ulcer. Therefore, Doctor of Nursing Practice (DNP) graduates is expected to provide their nursing knowledge acquired from base studies which test the effectiveness of practicing approaches that benefit both the patients and healthcare systems ( Broome & Riner, 2012). Therefore, this paper is also going to describe the essentials of DNP graduates in scholarly literature. Also increase it the number of staff of nurses who are knowledgeable on the pressure ulcer management will help in combating the pressure ulcer ( Manzano, 2011).
Therefore, the project is determined in implementing the pressure ulcer management strategies which aim at reducing the incidences of the disease, by reflecting on how the healthcare practitioners provide professional skills and essential knowledge intensive care nurses on better ways of handling and managing patients debilitated with skin infection through providing advanced training.
In the Intensive Care Unit (ICU), does the implementation of the Doctors of Nursing Practice program, lowers the risk of acquiring pressure ulcers compared to a time span of one month with no practicing of the program?
The pressure ulcer is believed through the reports revealed by different organizations that it mainly suppresses the elderly who are suffering from moderate conditions and are frequently hospitalized (Argawal, 2012). Because as an individual grows old, their skin becomes weak, dry and fragile, making them more vulnerable to the pressure ulcer.
Their many proper ways which can be implored when dealing with pressure ulcers, like; conventional bedside treatment by the caregiver, others also involves surgical treatment such as pressure therapy (Huang, 2011). It is becoming clear that DNP has provided a significant advancement in the healthcare system. As their role is to give required knowledge, to the nurses involve in the care of pressure ulcers patients. The intervention is to how the DNP addresses the implementation of the management of the pressure ulcer?
Many doctors and caregivers relate poor nutrition as an intervention in addressing pressure ulcers. However, there is no direct linkage between the two. Research then shows that providing excellent teachings to the caregivers can address the issue.
The project is expected to take a 21-week period which will entail conducting a program of teaching advanced skills and imparting knowledge to the caregivers and implementing the findings.
Advanced Nursing Practice
The increased advanced knowledge and expertise of healthcare have a lead, to the increase in specialization in nursing so that to ensure competence in the highly sophisticated areas of interest. The reality of the growth in specialization in nursing practice states that no person can master all of the advanced functions and the required knowledge and skills for enacting the roles. DNP programs, therefore, provide preparation within distinct specialties that require expertise, advanced knowledge and having mastery content in one area of nursing practice. A DNP graduate is thus, prepared to practice in a field of specialization within the entire area of nursing
The DNP graduates are then, expected to show excellent assessment skills and base training in their sphere of expertise. DNP programs also give learning experiences which are founded in a sampler of patient care settings, such as hospitals and community settings. These learning experiences are supposed to be integrated during the DNP program of study, to give additional practice skills beyond those acquired in degree and masters of a nursing program. The experience gained during the program should give nurses enough skills to give practice decisions and understand the patient care consequences of decisions. A DNP graduate is entitled to some functions prepared for specialty nursing practice, including; Conducting a comprehensive and regular checking of health and illness, addressing in stressful situations, putting various and culturally sensitive approaches. Designing, implementing and evaluating therapeutic interventions regarding nursing. The nurses are also able to Develop and sustain therapeutic relationships and partnerships with the patient and other practitioners to facilitate optimal care to patient outcomes. Showing advanced levels of clinical judgment, critical system thinking, and evaluating evidence-based care to improve patient outcomes. They can guide, mentor, and give support to other nurses to achieve excellence in nursing practice. Providing guidelines for individuals and communities, through difficult health and situational incidences. Also, they should be able to use conceptual and analytical skills in evaluating the links among practice and policy issues.
Organization and Systems Leadership for Quality Improvement and Systems Thinking in DNP
DNP graduates must be equipped with organizational and systems leadership skills to improve patient outcome (AACN, 2012). DNP graduates' practice focus on the needs of patients, a targeted populations or a broad community. Graduates are expected to have skills in working within organizational and policy arenas and in the actual delivery of patient care by themselves and others. For instance, its recommendable that the DNP graduates to understand the principles of practice management Including conceptual and practical strategies that balance productivity with the quality of care (Gatti & Karl, 2013). They should evaluate the impact of practice policies and quality improvement strategies in organizational and policy levels. ( Moran 2017) Furthermore, DNP graduates can organize care to address emerging practice difficulties and the ethical dilemmas that pop up as new diagnostic technologies evolve. Again, DNP graduates are capable of assessing risk and coming together to manage risks ethically, based on professional standards.
Thus, the advanced nursing practice has an organizational and systems leadership program that emphasizes training, ongoing improvement of health outcomes, and ensures patient safety.(Porter & Kelly 2014). For all situations, thenurses should be prepared with knowledge in evaluating organizations and facilitating organization-wide changes in practice delivery.
Indeed, pressure ulcers are presenting a lot challenges to the healthcare settings, thus, the caregivers, the patients and the organization at large as indicated by research. With the incidences of pressure ulcer increasing at a higher rate, the problem must be addressed fast. The study gives an alternative of not only taking treatment as the only way of the solving the issue. Because treating pressure ulcers is becoming more expensive with time and this might limit those that cannot acquire acute healthcare systems. Therefore, funds should be set aside for driving DNP program that creates awareness to caregivers by providing essential advanced skills and knowledge in handling and managing the issue of pressure ulcer (Black & Kalowes, 2016). Therefore, being pressure ulcer is a manageable condition, if right investments are made towards a project like this, then it is clear that, in the coming few years, pressure ulcer will be a thing of the past.
American Association of Colleges of Nursing [AACN]. (2012). The essentials of doctoral education for advanced nursing practice. Washington, DC: Author.
Broome, M. E., Riner, M. E., & Allam, E. S. (2013). Scholarly publication practices of doctor of nursing practice-prepared nurses. Journal of Nursing Education, 52(8), 429-434. doi: 10.3928/01484834-20130718-02
Bhattacharya, S., & Mishra, R. K., (2015). Pressure Ulcers: Current Understanding and newer Modalities of Treatment. Indian Journal of Plastic Surgery, 48(1): 4-16
Black, J., & Kalowes, P. (2016). Medical device-related pressure ulcers. Chronic Wound Care Management and Respiratory Care, 3, 91-99.
Fawcett, J., & Desanto-Madeya, S. (2012). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories. FA Davis.
Lahmann, N. A. & Kottner, J. (2011). The relation between pressure, friction, and pressure ulcercategories: a secondary data analysis of hospital patients using CHAID methods. International Journal of Nursing Studies, 48(12), 1487-1494.
Shader, K., Broome, M. E., Broome, C. D., West, M. E., & Nash, M. (2011). Factors influencing satisfaction and anticipated turnover for nurses in an academic medical center. Journal of Nursing Administration, 31(4), 210-216.
Jaul, E. (2013). A cohort study of a typical pressure ulcers development. Int Wound J, 11 (6), 696-700. doi:10.1111/iwj.12033
Porter, M., & Kelly, J. (2014). Pressure ulcer treatment in a patient with spina bifida. Nursing Standard, 28(35), 60-69. Do 10.7748/ns2014. 04.28.35.60. e7943
Moran, K., Burson, R., Conrad, D. (2017) The Doctor of Nursing Practice Scholarly Project. (2nd ed). Burlington, MA: Jones & Bartlett.
Reddy, M., Gill, S., & Rochon, P. (2010). Preventing Pressure Ulcers: A Systematic Review. JAMA, 296 (8), 974. doi:10.1001/jama.296.8.974
Huang, D. T., Clermont, G., Kong, L., Weissfeld, L. A., Sexton, J. B., Rowan, K. M., & Angus, D. C. (2011). Intensive Care unit safety c...
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