Decubitus ulcer prevention

The sores are staged according to the depth of soft tissue damage of the sore; stage one to stage four with the stage four being deeper and more severe damage to the wound. In hospital inpatient settings, patients who are immobile due to illness or unable to turn themselves are at high risk of developing decubitus ulcers as pressure on the skin is sustained for a long period of time. Incontinent patients are also at higher risks of developing pressure sores due to the often-wet environment, patient surrounding also such as rugged beddings also increase the risk of developing decubitus ulcers (Wang et al. The development of pressure sores in patients acts as an indicator of the level of patient’s quality of care; pressure sores in the care settings ought not to occur.

Decubitus ulcers negatively impact a patient's experience of care, increase their dependency on care and may increase their risks of acquiring hospital-associated infections during hospitalization (Wang et al. The first stage of Lewin's change theory is unfreezing. This stage of change is the stage where the change is communicated, education is delivered on the proposed change and motivation for the change is provided (Yoder-Wise, 2016). At this stage, the team is enlightened on the new way of doing things and are primed to shift from the previous approach of working to adopt the new approaches. At this stage of change, the change will be communicated and preparations for the change instituted. The second stage of change is referred to as moving and involves the actual implementation of the change intended.

The Lewin change theory identifies the existence of barriers to change and driving forces to the change process (Yoder-Wise, 2016). In the unfreezing stage, the driving forces are emphasized and the restraining forces are discouraged. The motivating factors to change in the environment will include the reduction in legal risks that would be tied to staff performance, availability of evidence to support the change and the hospital leadership involvement in the change. The restraining forces to the change will include those staff preferring to maintain status quo and limit change, staffing levels per unit, and limited information on the need for change. To mitigate that, staff will be provided with adequate information and resources on the new processes and changes to be implemented and allowed time to review and discuss as well as ask questions on the changes.

Supportive supervision by the evidence-based committee, hospital administration teams and nurse leaders will be conducted during the second month. The supportive supervision will aim to identify any flaws in implementing the changes and ensure such are corrected and that the new processes are adhered to and maintained. This is critical to the change process as it will ensure that the teams do not revert to the old ways. The process will be maintained and a reward trophy for the best performing units will be presented at the end of each month. Benchmarking among the units will be promoted to encourage sharing of ideas and motivating the maintenance of the changes made and ensure sustainability. gov. Retrieved 15 April 2018, from https://www. ahrq.