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Benchmark: Evidence Based Practice Proposal
Final Paper
Jennifer Vega, BSN, RN
Grand Canyon University
NUR-590
Professor Gina Walker
September 8, 2021
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Problem Statement
(P) Over the past year, there has been an increase in the incidence of pressure injuries seen in
the patient admitted to the ICU, therefore, (I) a new pressure injury prevention bundle (PIPB)
will be implemented as (C) compared to using only single interventions to (O) reduce/eliminate
the formation of new pressure injuries and improve patient outcomes (T) over a period of 8
weeks. This project was developed with the needs of Hialeah Hospital in mind. Hialeah
Hospital is a for-profit acute care community hospital with three hundred seventy-eight beds and
is committed providing compassionate, safe, high-quality care. Their mission statement is to
provide care to its patients with quality, safety, and service. They have received a number of
awards and accreditations, including the Beacon Award of Excellence for the Intensive Care Unit
(ICU) in 2020, Heart Failure Gold Plus Award in 2018, Target Stroke Gold Plus Award in 2018,
Blue Distinction Specialty Care Bariatric Surgery in 2019, Advanced Primary Stroke Center
Accreditation in 2018 (Hialeah Hospital, 2021). This Beacon Award is the strongest driving
force behind this project, as it is important to the leaders to continue providing care for its
patients with the highest quality care possible.
COVID-19 increased the incidence of hospital-acquired pressure injuries (HAPIs) in the
patient admitted to the ICU. The alarming increase of HAPIs forced meetings with the Wound
Care Coordinator to discuss ways to improve the outcomes of the patients admitted. It was
found that COVID put patients at a higher risk for developing pressure injuries. Medical devices
were also found to be creating pressure injuries. These findings prompted the need to research
new interventions after the traditional ones were found to be ineffective. This topic is important
to nursing because the development of pressure injuries increases the length of stay for most of
these patients and can affect hospital ratings and patient satisfaction.
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Organizational Culture
The culture of an organization is what guides its practices and processes. The organization
where the evidence-based project (EBP) will take place has a culture that relies heavily on using
teamwork to provide care to its patients using quality, safety, and service to maintain positive
patient outcomes. Its motto is “A Community Built on Care” and the organization strives every
day to provide the best care possible based on the latest evidence-based research. The
organization believes in using an interdisciplinary approach to patient care. It encourages care
based on the collaboration and insight of the different interdisciplinary team members. The use
of an interdisciplinary team in implementing EBPs allows for the patient’s care to be developed
using an approach that addresses all facets of the individual’s health (Amon, 2019).
Readiness Assessment
To ensure the success of a new evidence-based practice (EBP) in this facility, an
Organizational Culture and Readiness Assessment for the organization was conducted which
gave a good indication of the culture of this organization and on the readiness of the organization
to support the changes needed for this EBP to be successful. The readiness tool selected for this
project was recommended by Melnyk and Fineout-Overholt and is used to assess the culture and
readiness of the organization to implement a new evidence-based practice (Melnyk & FineoutOverholt, 2015). The survey which is based on a scale of 0 to 5, indicated that the organization
was moderately ready to incorporate an EBP in the clinical setting; the organization scored an
average of 4 with 5 being the highest. The organization’s leadership team changed its approach
towards nursing and is making every effort to educate the staff regarding the importance of EBP
and the positive impact it will have on patient care. This survey showed that the commitment to
EBP by the leaders and the financial resources provided to support EBP scored significantly
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higher. Through the shared governance council, nurses are encouraged by leaders to identify
issues within the organization and research potential EBP interventions with the support of a
mentor. This is where the project will be presented but, the number of individuals within the
organization that have extensive knowledge of the EBP process is very limited. This issue can
be resolved by assigning a dedicated EBP trained educational resource, such as the hospital
Nurse Educator, that can guide the nurses in researching different databases and interventions for
evidence (DeNisco & Barker, 2016).
A potential barrier to this project will be trying to increase the interest of the staff nurses.
Some of the barriers identified by the nurses were lack of the right equipment or supplies, lack of
time, and staff shortages. The more experienced nurses often expressed a lack of interest in
learning and implementing a new EBP into practice; many of them do not understand the need
for change. Another barrier that may be easier to overcome will be gaining approval from upper
management to invest the time and resources in the EBP because it cannot be implemented
successfully without the appropriate knowledgebase, staffing, tools, and equipment needed. The
individuals that can assist with eliminating some of the project barriers are the nurse educator,
nurse managers, and some of the physicians since they work closely with the critical nursing
staff and can help to encourage the use of EBP in the clinical setting. “The organization is on the
right path by identifying the need to change, however by addressing the weaknesses with
appropriate proponents and building on the strengths of the culture, the organization will be
ready to integrate evidence-based practice” (DeNisco & Barker, 2016).
Stakeholders, Team Members, and Readiness
For this project, an interdisciplinary team will be established to address the increase in
pressure injuries seen in patients admitted to the intensive care unit. The team will include the
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nurse manager, the wound care coordinator, respiratory therapy, director of quality, dietician,
supply chain director, staff nurse, unit director, CNO, physical therapy (PT), and case
management. The nurse manager and wound care nurse will coordinate meetings for the team
and will round on unit patients weekly, focusing more on those identified as being at high risk
and those with existing pressure injuries (PIs); those will be seen daily by wound care. The
wound care nurse will assess the patients for any needed preventions and will initiate the
prevention bundle, including adding consultations for members of the interdisciplinary team to
evaluate the patients’ additional needs. The staff nurse will be responsible for wound care on
patients with PIs stage I and II and will ensure that the orders are carried out. PT will be
responsible for wound care on patients with PIs stage III and above. Respiratory therapy will
check for skin breakdown below the BiPAP masks, will check behind the ears for breakdown
caused by nasal cannulas, and will check under the endotracheal tube (ETT) commercial holder
for breakdown of the lip and mouth. The director of quality and the CNO will review reports
compiled using the hospital’s current electronic health record (EHR) and provide guidance for
additional interventions. Using the existing EHR, allows the team to create a treatment bundle
that can be used to ensure that none of the components of the PIPB are missed. Dieticians will
review patient labs and order any needed supplements that can aid in the wound healing process.
Case managers will be part of the team to assess any barriers that may prolong the discharge
process.
Literature Review Search Methods
The search method used for the articles used for this EBP included one or more combinations
of the keywords; “pressure injuries”, “preventing pressure ulcers”, “translational”, “preventing
pressure injuries”, “intervention”, “pressure ulcers”, “research”, “wounds”, “hospital-acquired”,
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and “pressure sores”. The databases used for the research were Medline, PubMed, Embase,
Scopus and CINAHL Complete (via EbscoHost), which were all accessible through the GCU
library. These databases met the research criteria because they contain countless research studies
related to health and the articles were chosen with publication dates from 2016 forward. Manual
searches were conducted through google scholar that could be used as a guide in finding other
potential articles this project could benefit from.
Synthesis of Literature
In their quantitative study, Amoldeep et al. (2019) aimed to assess the practices of nurses
regarding the prevention of pressure ulcers among patients and to develop guidelines for the care
of pressure points. The researchers selected one hundred fifty seven nurses by using a total
enumerative sampling technique. Each of the nurses was given a questionnaire that assessed
their practices for pressure injury prevention (PIP). This study revealed that gender and area of
work were found to be significant in their practices. It also revealed that nurses do not assess
patients for the presence of pressure ulcers or use a risk assessment tool to determine their risks
for developing pressure injuries (PI). This article helps to supports the proposed EBP practice
project because it emphasizes the importance of implementing guidelines to prevent pressure
ulcers and in educating the nurses on the standards.
In another quantitative study, Amon et al. (2019) aimed to decrease the prevalence of
hospital-acquired pressure injuries (HAPI) below the National Database of Nursing Quality
Indicators (NDNQI) monthly mean by implementing a bundled intervention program. Using a
FOCUS-PDCA methodology, the team created an improvement plan with a bundled approach to
address 6 strategies for HAPI prevention comprehensively and applied it to patients in a thirtytwo-bed adult medical-surgical telemetry unit. Researchers also created a team to monitor the
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success of the interventions. Findings showed that creating a PIP bundle and specialized team to
monitor progress, prevented the incidences of PIs for one hundred consecutive days. This article
helps to supports the proposed EBP practice project because it gave examples of interventions to
include in the Pressure Injury Prevention (PIP) bundle and gave a great example of the team that
can be established to monitor and analyze the interventions and data collected.
Using a scientific methodology, Copasso et al. (2020) created a guideline to prevent the
incidences of PIs in proned patients. They used specialized proning beds whenever possible and,
when not possible, manual proning was done using specialized support surfaces and positioning
devices. This study found that using these techniques greatly reduced the number of PIs seen in
patients that were proned. This article helps to support the proposed EBP practice project
because it can help aid in the prevention of pressure injuries when proning patients.
In a quantitative intervention before and after study, Deakin et al. (2020) implemented and
evaluated an evidence-based PIP care bundle in three hospitals and determined the patient
satisfaction with the interventions. This study was conducted across three, twenty-eight bed
acute medical units (respiratory, medical, and infectious diseases) at a seven hundred fifty bed
tertiary hospital in Queensland, Australia and a questionnaire was used to assess patient
satisfaction. Researchers found that the PIP care bundle was associated with increasing patients’
self-reported knowledge of PIs and that patients were satisfied with the delivered intervention.
Nursing staff also reported that the PIP care bundle would assist them in educating patients in PI
prevention. This article helps to support the proposed EBP practice project because it examines
the importance of educating patients regarding PIP to allow them to participate in their care and
aid in the prevention of HAPIs.
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In a quantitative study conducted by Fremmelevholm and Soegaard (2019), the aim was to
reduce PIs by fifty at the hospital and to have none at category III (full thickness skin loss) or
higher. This study included all inpatients fifteen years and older from all departments, including
intensive care units, who are self-sufficient in their personal care and can ambulate. They used
different QI methods to develop PIP interventions and established a committee to evaluate the
findings. The results from the studies showed that the goal of fifty percent reduction was
surpassed. In 2012 and 2013 five category III pressure ulcers and one category IV pressure ulcer
were found. In 2016 and 2017 no pressure ulcers of category III or above were found and only
one category III pressure was found in 2018. This article supports the proposed EBP practice
project because it addresses interventions that can be put in place to establish an effective PIP.
In a mixed-method study, Guzman et al. (2018) aimed to improve the competency of nurses
in pressure ulcer risk assessment and prevention by developing guidelines for pressure ulcer
prevention and providing education and a competency evaluation tool based on the guidelines.
A survey was conducted in the ICU, PCU and MS units and included patients with pressure
injuries, some that were hospital-acquired. Edwards Deming’s Plan Do Study Act (PDSA)
model was used and data regarding pressure ulcers and guideline adherence was collected
through a Hill Rom IPIP survey. A questionnaire was also used to assess the nurses’ feelings
regarding PIP. The comparison of the survey results from 2016 and 2018 revealed that there was
a decrease in HAPUs. The questionnaire given to the nurses revealed that twenty-five percent of
them felt that pressure ulcer prevention was time consuming, ninety-three percent of the nurses
believed that treatment was not a priority over prevention, and fifteen percent of the nurses did
not feel that most pressure ulcers could be prevented. This article supports the proposed EBP
practice project as it discusses the importance of following the pressure injury prevention
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guidelines and in listening to the feelings and opinions of the nurses in developing an effective
prevention program.
The study conducted by Kurmis et al. (2021) aimed to review the evidence accessible from the
past decade that addressed nutritional interventions in wound healing. A literature review was
conducted using 61 studies that evaluated the effects of nutrition on wound healing. The
findings indicated that nutrition is an important component of best practice wound care. Despite
the range of identified research over the past decade in this area, multiple nutritional strategies
for various wound types are evolving. This article supports the proposed EBP practice project
because it addresses the importance of nutrition in the wound healing process.
In their study, Roberts et al. (2017) wanted to identify patients’ perceptions and experiences
of PIP care bundles. A trained interviewer conducted semi-structured interviews, which were
digitally recorded, transcribed, and analyzed using thematic analysis. Nineteen patients were
interviewed across the four hospitals and three concepts developed which were (a) importance of
personal contact in PIP care bundle delivery; (b) understanding PIP enhances participation; and
(c) individual factors impact patients’ engagement in PIP. This study found that patients
accepted a PIP care bundle that encouraged participation in care, particularly as it involved
personal and positive interactions with nurses and delivery of information that was easy to
understand and resonated with patients. This article supports the proposed EBP practice project
because it addresses the need to include the patient in the care process and to educate them in a
manner that is easy to understand.
Comparison
After reviewing the articles seven of them identified that implementation of a PIP care bundle
was effective in reducing the incidences of pressure injuries. They discussed the importance of
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creating bundles that addressed several interventions that together helped reduce and sometimes
even prevent the development of hospital acquire pressure injuries. Five of the articles identified
education as an important factor in PIP. They discussed educating both the patient and the nurse
and evaluating their feelings and perceptions regarding the interventions. Only one article
discussed nutrition as an intervention but identified it as an important factor in wound healing
and prevention.
Future Research
The prevention of PIs requires further research to determine which implementations are most
effective. Another factor that warrants further research is the nurses’ assessment of patients at
high risk for developing PIs allowing them to identify those patients without the use of formal
assessment tools such as the Braden score. The impact of education of the nurses and patients is
also something that warrants further investigation to determine the effect it has on the prevention
or the worsening of pressure injuries. Nutrition has been found to have a large impact on wound
prevention and healing. Current available guidelines provide a broad uniformity regarding
macronutrient recommendations; however, evidence for other nutrient recommendations remains
lacking, especially related to the best possible timing and dosage.
Change Model and Framework
This project will use the Rosswurm and Larrabee model of change to implement a new bundle
approach intervention based on evidence-based research to try and decrease the incidence of
pressure injuries in the critical care unit. This is a model that can be used by nurses and other
healthcare professionals to implement new evidence-based practices into everyday nursing care.
As stated by Gawlinsky and Rutledge (2018), using change models is a great way to ensure that
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the implementation process is complete, that evaluations are done in a timely manner, and helps
to appropriately use time and resources.
Implementing Change
The model consists of six stages; assess, link, synthesize, design, implement and evaluate, and
integrate and maintain. First, the facility is assessed for a need for a change in practice. An
assessment of the data collected during rounds supports the need for new interventions to
decrease the incidence of HAPIs. This data will be compared to data collected through research.
Second, the issue identified is linked with interventions and outcomes. The data collected helped
help some current interventions with the negative patient outcomes and further assisted in
developing new PIPBs that could potentially improve patient outcomes. Third, the best evidence
is synthesized by conducting a literature review and evaluation of research based on the topic.
Those results are combined with qualitative data, clinical reasoning, and appropriate data to
ensure that the benefits of the interventions outweigh any potential risks to the patients. Fourth,
a new practice protocol is designed for the changes that will be made to current practices that
considers the environment where the change will be made, the resources available, and feedback
from everyone involved in the project. The new interventions will be explained to the staff and
implemented into the daily wound care practices. Staff and patient outcomes will be monitored
using rounds and any additional education for the staff will be conducted. Lastly, if the outcomes
are favorable, the practice change is integrated and maintained in the everyday care of the
patients and the PIPB will become a regular part of nursing practice.
This change model is effective for use in the facility and environment because it is the one
that most closely relates to the motto of the hospital which is “A Community Built on Care.”
The facility encourages taking care of the patient using quality, safety, and service. This is
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incorporated by using an interdisciplinary team approach to patient care and using the latest
evidence-based research to do so.
Implementation Setting
As previously stated, this project will take place in Hialeah Hospital in the Intensive Care
Unit which has a total of twenty-one beds. The patients in this unit will not need to sign a
consent for the services as it will be incorporated into their routine daily care and will be initially
evaluated by the wound care nurse and project leader. The bedside nurses will perform skin
assessments every shift to evaluate for any changes in the patient’s skin condition and any
findings will be documented in the computer system under the Incision and Wound section. The
findings will be confirmed by the wound care nurse during patient rounds. Documentation will
be reviewed by the project leader to ensure that all interventions included in the pressure injury
prevention bundle (PIPB) are being carried out and any fallouts will be reported to the project
leader to be addressed with the bedside nurse.
Timeline
The estimated timeline for this EBP project will be eight weeks and will begin with the
assessment and identification of patients who are at high risk for developing PIs and those with
existing PIs. It will involve research that acknowledges the best evidence related to the goals of
project (Holland & Forrest, 2017). The first two days will be comprised of meetings with all the
stakeholders to discuss the expectations of the project. The goals for this project will also be
discussed and any changes discussed in the meetings will be made. Research data will be
collected, evaluated, and reviewed with the stakeholders within the first week. Potential barriers
will be identified, and all evidence collected that supports the need for the changes will be
presented to potentially remove any barriers. All stakeholders will be educated on the different
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components of the PIPB and on how to implement it. Data regarding patient outcomes will be
collected and reviewed during rounds and the final phase of the project will involve reviewing
the implementation process and the data related to the patient outcomes.
Budget, Resources, and Feasibility
The projected budget for this project is approximately $3548. The cost of this project is as
follows: Wedge positioners $900, Wound Care Coordinator $360, Nurse Educator $376, Supply
Chain Manager $100, Physical therapy $144, Respiratory therapy $100, Dietician $100, Case
management $144, Director of Quality $400, ICU director $384, and CNO $640. The cost of the
stakeholders is based on each individual’s hourly rate times one hour per week for meeting for a
total of eight weeks. This plan is feasible, and the cost is minimal in comparison to the cost the
hospital will sustain from any HAPIs because they increase the patient’s length of stay and
causes an increase in the need for resources to accommodate the patient’s needs. Keeping the
length of stay down to a minimum is essential to ensure that patients are cared for and discharged
as soon as possible to accommodate for other patients that may need ICU beds and developing a
budget to benefit our patients’ outcomes “…demonstrates to staff nurses that the education and
implementation of EBP is valued by leadership” (Melynk and Fineout-Overholt, 2018).
Implementation Process and Stakeholder Responsibilities
Each interdisciplinary team member needs to be aware of the changes needing to be made and
what their role is in this project. The nurse educator will meet and discuss the process of EBP
implementations and educate the stakeholders regarding the interventions in the PIPB and on
their individual role will be. To measure the quality of care delivered, the Director of Quality
and the CNO will use a performance improvement measure, known as benchmarking, to monitor
the success of the newly implemented evidence-based practices. “Benchmarking allows us to
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identify best practices in care and can be used to accurately track quality improvement progress”
(CMS.gov, 2021).
Evaluation Process
A quantitative approach will be used for this EBP project because of the importance of
collecting data regarding patient outcomes and statistical tests will be used to measure the
effectiveness of the PIPB. These tests can be used to establish whether a variable has a
significant relationship to an outcome variable and/or to estimate the difference between two or
more groups. “Statistical tests work by calculating a test statistic– a number that describes how
much the relationship between variables in your test differs from the null hypothesis of no
relationship” (Bevans, 2020). This project will focus on using regression tests which evaluate
cause-and-effect relationships. They look for the effect of one or more constant component on
the other. Using this method would be best because for the measuring patient outcomes because
it would answer the question if using the PIPB helps to reduce the incidence of HAPIs in the
ICU.
The hospital’s current clinical decision support tool will be used to track and trend findings
that can be evaluated during patient rounds and through documentation. “Clinical decision
support (CDS) provides clinicians, staff, patients or other individuals with knowledge and
person-specific information, intelligently filtered or presented at appropriate times, to enhance
health and health care” (AHRQ, 2019). This tool measures the effectiveness of the
interventions allows each individual involved to understand how their actions affect the
outcomes.
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Strategies and Plans
As previously stated, weekly meetings will be conducted to discuss the progress of the EBP
project and adjustments will be made as needed. If the interventions are ineffective and new
HAPIs develop, they will be discussed during nursing huddles and research will be conducted
to incorporate any new practices that have been found to be effective in preventing HAPIs. If
the PIPB is found to be effective, plans will be made to develop a policy that will put into
practice throughout the rest of the units in the hospital. Patients will be monitored, and the
interventions will be customized to meet the needs of the individual patients. Continuous
education and research will be key in keeping the PIPB as up to date as possible so that patient
outcomes can continue to improve.
Conclusion
The prevention of pressure injuries is an important topic in health care today. Guidelines and
interventions need to be developed to facilitate the reduction of incidences of HAPIs. Several
studies have been conducted related to this topic but there are still many unanswered questions
related to this topic. The creation and implementation of PIP care bundles and education seem to
be the most effective way of combating this issue to date.
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References
(2021, August 2). Retrieved from Hialeah Hospital: https://www.hialeahhosp.org/
Amoldeep, B. D. (2019). Practices Followed by Nurses for Prevention of Pressure Ulcer Among
Patients Admitted in Tertiary Rural Care Hospital. International Journal of Nursing
Education. Retrieved from
https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true
&db=ccm&AN=137636460&site=edslive&scope=site&custid=s8333196&groupid=main&profile=eds1
Amon, B. V. (2019). Achieving 1,000 Days with Zero Hospital-Acquired Pressure Injuries on a
Medical-Surgical Telemetry Unit. MEDSURG Nursing, 28(1), 17-21.
Bevans, R. (2020, January 28). Retrieved from Scribbr:

Capasso, D. V., Cox, D. J., Cuddigan, D. J., Delmore, D. B., Tescher, D. A., & Solmos, S.
(2020). National Pressure Injury Advisory Panel. Retrieved from NPIAP.com:
https://npiap.com/?
Clinical Decision Support. Content last retrieved June 2019. Agency for Healthcare Research
and Quality, Rockville, MD. https://www.ahrq.gov/cpi/about/otherwebsites/clinicaldecision-support/index.html
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CMS.gov. (2021). Retrieved from Centers for Medicare and Medicaid Services:
https://www.cms.gov/Medicare/Quality-Initiatives-Patient-AssessmentInstruments/MMS/Quality-Measure-and-Quality-Improvement-
Deakin J, G. B. (2020). An education intervention care bundle to improve hospitalised patients’
pressure injury prevention knowledge: a before and after study. Wound Practice &
Research. Retrieved from
https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true
&db=ccm&AN=147661225&site=edslive&scope=site&custid=s8333196&groupid=main&profile=eds1
DeNisco, M. S., & Barker, M. A. (2016). Advanced Practice Nursing. Essential Knowledge for
the Profession. Third Edition. Jones & Bartlett Learning, LLC. Retrieved July 24, 2019,
from https://viewer.gcu.edu/Tce3cz
Fremmelevholm, A., & Soegaard, K. (2019). Pressure ulcer prevention in hospitals: a successful
nurse-led clinical quality improvement intervention. British Journal of Nursing, 28(6),
S6–S11. https://doi-org.lopes.idm.oclc.org/10.12968/bjon.2019.28.6.S6
Gawlinski, Anna D. R. & Rutledge, D. (2008). Selecting a Model for Evidence-Based Practice
Changes. AACN Advanced Critical Care, Volume 19(Issue 3), pp. 291-300
Guzman Jennifer L., M. R. (2018). Development of guidelines for pressure ulcer prevention.
Wounds International. Retrieved from
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https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true
&db=ccm&AN=134167799&site=edslive&scope=site&custid=s8333196&groupid=main&profile=eds1
Holland, R. A., & Forrest, B. K. (2017). Good arguments: Making your case in writing and
public speaking. Baker Academic
Kurmis R., W. M. (2021). The importance of nutrition in wound management: new evidence
from the past decade. Wound Practice and Research. Retrieved from
https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true
&db=ccm&AN=150219150&site=edslive&scope=site&custid=s8333196&groupid=main&profile=eds1
Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare.
A guide to best practice (3rd ed.) (pp. 3–23). Philadelphia, PA: Wolters Kluwer.
Roberts, S., Wallis, M., McInnes, E., Bucknall, T., Banks, M., Ball, L., & Chaboyer, W. (2017).
Patients’ Perceptions of a Pressure Ulcer Prevention Care Bundle in Hospital: A
Qualitative Descriptive Study to Guide Evidence-Based Practice. Worldviews on
Evidence-Based Nursing, 14(5), 385–393.
https://doi-org.lopes.idm.oclc.org/10.1111/wvn.12226
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Appendix
I.
APA Writing Checklist
II.
Concept Map
III.
Timeline
IV.
Resources List
V.
Budget
VI.
Quote
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APA Writing Checklist
Use this document as a checklist for each paper you will write throughout your GCU graduate program.
Follow specific instructions indicated in the assignment and use this checklist to help ensure correct
grammar and APA formatting. Refer to the APA resources available in the GCU Library and Student
Success Center.
☒ APA paper template (located in the Student Success Center/Writing Center) is utilized for the correct
format of the paper. APA style is applied, and format is correct throughout.
☒ The title page is present. APA format is applied correctly. There are no errors.
☒ The introduction is present. APA format is applied correctly. There are no errors.
☒ Topic is well defined.
☒ Strong thesis statement is included in the introduction of the paper.
☒ The thesis statement is consistently threaded throughout the paper and included in the conclusion.
☒ Paragraph development: Each paragraph has an introductory statement, two or three sentences as the
body of the paragraph, and a transition sentence to facilitate the flow of information. The sections
of the main body are organized to reflect the main points of the author. APA format is applied
correctly. There are no errors.
☒ All sources are cited. APA style and format are correctly applied and are free from error.
☒ Sources are completely and correctly documented on a References page, as appropriate to assignment
and APA style, and format is free of error.
Scholarly Resources: Scholarly resources are written with a focus on a specific subject discipline and usually written by an expert in
the same subject field. Scholarly resources are written for an academic audience.
Examples of Scholarly Resources include: Academic journals, books written by experts in a field, and formally published
encyclopedias and dictionaries.
Peer-Reviewed Journals: Peer-reviewed journals are evaluated prior to publication by experts in the journal’s subject discipline. This
process ensures that the articles published within the journal are academically rigorous and meet the required expectations of an article
in that subject discipline.
Empirical Journal Article: This type of scholarly resource is a subset of scholarly articles that reports the original finding of an
observational or experimental research study. Common aspects found within an empirical article include: literature review,
methodology, results, and discussion.
Adapted from “Evaluating Resources: Defining Scholarly Resources,” located in Research Guides in the GCU Library.
☒ The writer is clearly in command of standard, written, academic English. Utilize writing resources
such as Grammarly, LopesWrite report, and ThinkingStorm to check your writing.
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Concept Map
1. Assess
2.Link
Need for
change in
Practice
Problem
Intervention
and
Outcomes
Review of
negative
patient
outcomes
regarding
HAPIs is done.
Assessment of
data collected
during rounds
is done. Collect
data
Review what is
currently being
done and link
their
ineffectiveness
to the negative
patient
outcomes
related to
HAPIs.
5.Implement and
Evaluate change in
Practice
Implement the PIPB and
evaluate the patient
outcomes related to the
PIPB by rounding and
reviewing data collected.
3.Synthesize
Best
Evidence
Conduct
research and
compare
interventions
being done to
what is found
in the
research.
Assess the
benefits of
implementing
the changes.
4.Design
Practice
Change
Create the PIPB
based on
research
findings, create
interdisciplinary
team, address
the resources
needed,
educate, and
educate
stakeholders
regarding
expected
outcomes of
reduced HAPIs.
6. Integrate and
Maintain
Change in
Practice
Conduct final meetings at
the end of project to
discuss outcomes. If PIPB
effective, discuss ways to
incorporate it into daily
practice. Create policy to
distribute to other units to
standardize its use
throughout the facility.
Continue to monitor
outcomes and make
changes as needed.
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Timeline
Week 1:
Monday: Meeting with Wound Care Coordinator to identify necessary stakeholders and their
roles
Tuesday: Meeting with stakeholders to discuss the assigned roles
Wednesday: Research Day!!
Thursday: Reviewing collected research and finalizing the pressure injury prevention bundle
(PIPB)
Friday: Discussing the bundle and educating the stakeholders on their responsibilities
Week 2:
Monday: Rounds with the Wound Care Coordinator to identify patients meeting criteria for the
PIPB
Tuesday through Thursday: Education regarding the PIPB and how to implement the different
components
Friday: Rounds with Wound Care Coordinator to answer questions and assist with any needs
Week 3 through 7:
Mondays and Thursdays: Rounds with Wound Care Coordinator to check implementation
process, answer questions, check progress of PIPB, and to identify any new patients meeting
criteria
Tuesday: Collection and review of data regarding outcomes
Friday: Weekly meeting with stakeholders to address any issues or concerns regarding the
outcomes
Week 8:
Monday and Tuesday: Rounds with Wound Care Coordinator to re-examine patients and collect
data regarding patient outcomes
Wednesday and Thursday: Reviewing data and creating presentation regarding outcomes
Friday: Present final outcomes to stakeholders and discuss any further needs
23
Resource List
1. Wound Care Coordinator
2. Nurse Educator
3. Supply Chain Manager
4. Director of Quality
5. ICU Director
6. CNO
7. Physical therapy
8. Respiratory Therapy
9. Dietician
10. Staff Nurses
11. Case management
24
Budget
◦
Estimated to be $3548
◦
Wedge positioners $900
◦
Stakeholder cost based on hourly rate per hour x 1 hour per week for meeting x 8
weeks:
◦
Wound Care Coordinator $360
◦
Nurse Educator $376
◦
Supply Chain Manager $100
◦
Physical therapy $144
◦
Respiratory therapy $100
◦
Dietician $100
◦
Case management $144
◦
Director of Quality $400
◦
ICU director $384
◦
CNO $640
25
26
Purchase Requisition Form
Date
Please type or print legibly.
Requested By
Jennifer Vega
Facility Name
Hialeah Hospital
Only utilize the Expense type checklist for capital/construction PO
Incomplete/incorrect information may result in the document being
returned
All PO’s will be processed within three business days from receipt
Department NamICU
Department #
Utilize for Capital/Construction and supply requests
6015
Required Date
Capital Expenditure Request #
Ship To Address
PO Number
Vendor Name
Medline
Vendor Number
25270
Vendor
Addres
Qty
11
Unit of
Measure Item #
2
Catalog #
MSC50025A
Item Description
Comfort Glide Foam Wedges
Representative
Dept #
6015
GL Sub
Account
Email [email protected]
Expense Type
Expense
Capital
Unit Cost Total Cost
$90.00
$990.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Reason for Purchase & Special Instructions
Subtotal
$990.00
Shipping
$0.00
Tax
$0.00
nd Total
$990.00
Rubric
Collapse All RubricCollapse All
collapse Description of Issue and Challenges assessment
Description of Issue and Challenges
14 points
Criteria Description
Description of Issue and Challenges
5. Target
14 points
A description of the issue and associated challenges is present and thorough.
4. Acceptable
12.88 points
A description of the issue and associated challenges is present and detailed.
3. Approaching
12.32 points
A description of the issue and associated challenges is present.
2. Insufficient
11.2 points
A description of the issue and associated challenges is present, but lacks detail or is incomplete.
1. Unsatisfactory
0 points
A description of the issue and associated challenges is not present.
collapse Utilizing EBP, Research, and PI assessment
Utilizing EBP, Research, and PI
16.8 points
Criteria Description
Utilizing EBP, Research, and PI
5. Target
16.8 points
An explanation of how EBP, research, and PI will be utilized is present and thorough.
4. Acceptable
15.46 points
An explanation of how EBP, research, and PI will be utilized is present and detailed.
3. Approaching
14.78 points
An explanation of how EBP, research, and PI will be utilized is present.
2. Insufficient
13.44 points
An explanation of how EBP, research, and PI will be utilized is present, but lacks detail or is
incomplete.
1. Unsatisfactory
0 points
An explanation of how EBP, research, and PI will be utilized is not present.
collapse PI and QI Process assessment
PI and QI Process
16.8 points
Criteria Description
PI and QI Process
5. Target
16.8 points
An explanation of the PI or QI process that would be applied and a discussion of why it was chosen are
present and thorough.
4. Acceptable
15.46 points
An explanation of the PI or QI process that would be applied and a discussion of why it was chosen are
present and detailed.
3. Approaching
14.78 points
An explanation of the PI or QI process that would be applied and a discussion of why it was chosen are
present.
2. Insufficient
13.44 points
An explanation of the PI or QI process that would be applied and a discussion of why it was chosen are
present, but lack detail or are incomplete.
1. Unsatisfactory
0 points
An explanation of the PI or QI process that would be applied and a discussion of why it was chosen are
not present.
collapse Data Sources assessment
Data Sources
16.8 points
Criteria Description
Data Sources
5. Target
16.8 points
An explanation of data sources, including outcome and process data, is present and thorough.
4. Acceptable
15.46 points
An explanation of data sources, including outcome and process data, is present and detailed.
3. Approaching
14.78 points
An explanation of data sources, including outcome and process data, is present.
2. Insufficient
13.44 points
An explanation of data sources, including outcome and process data, is present, but lacks detail or is
incomplete.
1. Unsatisfactory
0 points
An explanation of data sources, including outcome and process data, is not present.
collapse Capturing and Disseminating Data assessment
Capturing and Disseminating Data
16.8 points
Criteria Description
Capturing and Disseminating Data
5. Target
16.8 points
An explanation of how the data will be captured and disseminated is present and thorough.
4. Acceptable
15.46 points
An explanation of how the data will be captured and disseminated is present and detailed.
3. Approaching
14.78 points
An explanation of how the data will be captured and disseminated is present.
2. Insufficient
13.44 points
An explanation of how the data will be captured and disseminated is present, but lacks detail or is
incomplete.
1. Unsatisfactory
0 points
An explanation of how the data will be captured and disseminated is not present.
collapse Organizational Culture Considerations assessment
Organizational Culture Considerations
16.8 points
Criteria Description
Organizational Culture Considerations
5. Target
16.8 points
A discussion of which organizational culture considerations will be essential to the success of the
work is present and thorough.
4. Acceptable
15.46 points
A discussion of which organizational culture considerations will be essential to the success of the
work is present and detailed.
3. Approaching
14.78 points
A discussion of which organizational culture considerations will be essential to the success of the
work is present.
2. Insufficient
13.44 points
A discussion of which organizational culture considerations will be essential to the success of the
work is present, but lacks detail or is incomplete.
1. Unsatisfactory
0 points
A discussion of which organizational culture considerations will be essential to the success of the
work is not present.
collapse Thesis Development and Purpose assessment
Thesis Development and Purpose
9.8 points
Criteria Description
Communicates reason for writing and demonstrates awareness of audience.
5. Target
9.8 points
The thesis, position, or purpose is persuasively developed throughout and skillfully directed to a
specific audience.
4. Acceptable
9.02 points
The thesis, position, or purpose is clearly communicated throughout and clearly directed to a specific
audience
3. Approaching
8.62 points
The thesis, position, or purpose is adequately developed. An awareness of the appropriate audience is
demonstrated.
2. Insufficient
7.84 points
The thesis, position, or purpose is discernable in most aspects but is occasionally weak or unclear.
There is limited awareness of the appropriate audience
1. Unsatisfactory
0 points
The thesis, position, or purpose is not discernible. No awareness of the appropriate audience is
evident.
collapse Development, Structure, and Conclusion assessment
Development, Structure, and Conclusion
11.2 points
Criteria Description
Advances position or purpose throughout writing; conclusion aligns to and evolves from
development.
5. Target
11.2 points
The thesis, position, or purpose is coherently and cohesively advanced throughout. The progression of
ideas is coherent and unified. A convincing and unambiguous conclusion aligns to the development of
the purpose.
4. Acceptable
10.3 points
The thesis, position, or purpose is logically advanced throughout. The progression of ideas is coherent
and unified. A clear and plausible conclusion aligns to the development of the purpose.
3. Approaching
9.86 points
The thesis, position, or purpose is advanced in most aspects. Ideas clearly build on each other.
Conclusion aligns to the development of the purpose.
2. Insufficient
8.96 points
Limited advancement of thesis, position, or purpose is discernable. There are inconsistencies in
organization or the relationship of ideas. Conclusion is simplistic and not fully aligned to the
development of the purpose.
1. Unsatisfactory
0 points
No advancement of the thesis, position, or purpose is evident. Connections between paragraphs are
missing or inappropriate. No conclusion is offered.
collapse Evidence assessment
Evidence
7 points
Criteria Description
Selects and integrates evidence to support and advance position/purpose; considers other
perspectives.
5. Target
7 points
Comprehensive and compelling evidence is included. Multiple other perspectives are integrated
effectively.
4. Acceptable
6.44 points
Specific and appropriate evidence is included. Other perspectives are integrated.
3. Approaching
6.16 points
Relevant evidence that includes other perspectives is used.
2. Insufficient
5.6 points
Evidence is used but is insufficient or of limited relevance. Simplistic explanation or integration of
other perspectives is present.
1. Unsatisfactory
0 points
Evidence to support the thesis, position, or purpose is absent. The writing relies entirely on the
perspective of the writer.
collapse Mechanics of Writing assessment
Mechanics of Writing
7 points
Criteria Description
Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc.
5. Target
7 points
No errors in formatting or documentation are present. Selectivity in the use of direct quotations and
synthesis of sources is demonstrated.
4. Acceptable
6.44 points
Appropriate format and documentation are used with only minor errors.
3. Approaching
6.16 points
Appropriate format and documentation are used, although there are some obvious errors.
2. Insufficient
5.6 points
Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of
sources are evident.
1. Unsatisfactory
0 points
Appropriate format is not used. No documentation of sources is provided.
collapse Format/Documentation assessment
Format/Documentation
7 points
Criteria Description
Uses appropriate style, such as APA, MLA, etc., for college, subject, and level; documents sources using
citations, footnotes, references, bibliography, etc.)
5. Target
7 points
No errors in formatting or documentation are present. Selectivity in the use of direct quotations and
synthesis of sources is demonstrated.
4. Acceptable
6.44 points
Appropriate format and documentation are used with only minor errors.
3. Approaching
6.16 points
Appropriate format and documentation are used, although there are some obvious errors.
2. Insufficient
5.6 points
Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of
sources are evident.
1. Unsatisfactory
0 points
Appropriate format is not used. No documentation of sources is provided.

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