The prevention of hospital-acquired pressure injuries among adult immobilized patients in a mental health department: a best practice implementation project : JBI Evidence Implementation

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IMPLEMENTATION PROJECT

The prevention of hospital-acquired pressure injuries among adult immobilized patients in a mental health department: a best practice implementation project

Dobre, Claudia E. RN, BScN, MSc, PhD1,2; Gagiu, Corina RN, BScN, MSc1,2,3; Jitianu, Dorinela A. RN, BScN3; Zazu, Mariana RN, BScN, MSc1; Mazilu, Doina C. RN, BScN, MSc, PhD1,2; Jiménez, Marina Gallego RN, MSc4

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JBI Evidence Implementation 21(1):p 36-45, March 2023. | DOI: 10.1097/XEB.0000000000000325

Abstract

Objectives: 

The aim of this implementation project was to promote evidence-based practices regarding hospital-acquired pressure injuries prevention practices among immobilized adult patients in a mental health department and to measure the level of compliance with the best practice in this field.

Introduction: 

Pressure injuries can have significant restrictions on the patient's quality of life; affect the patient physically, psychologically, and socially; lead to increased costs and length of hospital stay; and are closely linked to increased mortality. Thus, the best evidence practice implementation project was conducted in the mental health ward of a large teaching hospital in Bucharest.

Method: 

The current evidence implementation project used the JBI Practical Application of Clinical Evidence System and Getting Research into Practice. The best practices project was carried out in a mental health department with 70 beds at Bucharest's largest mental health hospital. This analysis of nursing practice included all immobile patients who were hospitalized in the ward.

Results: 

Through the project to implement best practices for the prevention of pressure injuries, the activity of nurses was improved. If initially, the prevention of pressure injuries was a deficient activity in the hospital (compliance between 0 and 82%), after the implementation of the project, compliance with the recommendations of evidence-based practices was radically improved, obtaining a maximum percentage of 100% for all these activities: patient assessment, use of assessment tools, use of necessary devices, provision of high protein diet and patient education.

Conclusion: 

The current project contributed to the standardization and improvement of nurses’ practice of pressure injuries prevention in patients with mental illness and immobility hospitalized in a psychiatric ward. The development of future audits will help identify the sustainability of the implemented prevention measures.

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A video commentary on implementation project titled: How do health professionals prioritise clinical areas for implementation of evidence into practice? The commentary is provided by Andrea Rochon RN, MNSc, Research Assistant, Queen's University, Ontario, Canada