APPLYING NURSING RESEARCH TO PRACTICE

1 Running head: APPLYING NURSING RESEARCH TO PRACTICE

Applying Nursing Research to Practice

Candice Tester

Ohio University

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2 APPLYING NURSING RESEARCH TO PRACTICE

Applying Nursing Research to Practice

As being a critical care nurse for over eight years, I have seen many issues that need to be

improved with patient care. Pressure ulcers have always been a difficult issue, especially for

patients in the intensive care unit (ICU). With patient’s being critically ill, decreased mobility,

and use of medical devices, increases a patient’s risk for obtaining a pressure ulcer. There are

many interventions nurses have used over the years such as turning every two hours, cleaning

patient’s frequently from being incontinent, and frequent mobility. These interventions help if

done consistently but working in critical care can be fast paced and intense, leaving skin care low

priority. After thinking about this issue and researching, implementing the use of a preventative

silicone foam can help reduce the risk of obtaining a pressure ulcer in the ICU. The purpose of

this paper is to discover a best new practice to implement, describe the steps for implementation,

and provide literature to support the new practice.

Best Practice to Implement

Evidence-based practice is the use of current best practice while combining patient values

and clinical knowledge and expertise to make appropriate health care decisions about patient

care (LoBiondo-Wood & Haber, 2018). As nurses, it is our duty to always have the current

knowledge about what is best for patient care. The best practice I would like to implement is

applying a preventative silicone foam on ICU patients who are at risk for pressure ulcers.

Prevention is key for patients that are high risk for obtaining a pressure ulcer and implementing

the use of a silicone foam can decrease their risks. Early identification for patients at risk for

developing a pressure ulcer using the Braden Scale, can identify when to apply the preventative

foam on patients (Santamaria et al., 2015). A low Braden score can be contributed to a high risk

for developing pressure ulcers. Nurses assess skin, using the Braden Scale every shift, which

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3 APPLYING NURSING RESEARCH TO PRACTICE

helps identify who is at risk. Once established, the nurse can apply a silicone foam on the patient

as well as implement other pressure ulcer reducing methods. By utilizing the silicone foams, it

can greatly reduce the risk for patients obtaining a pressure ulcer.

Steps to Implementation

Once I have established a best new practice, there are other steps to be followed to

provide implementation in my facility. Nursing managers play a vital role in promoting

evidence-based practice (Kueny, Shever, Mackin, & Titler, 2015). Managers help educate and

implement the best practice for patient care on nursing units. After reviewing my facilities

policies and procedures for implementing a new practice, I would have to obtain approval from

my nursing manager. Once approved by the manager, we would submit a quality improvement

project to the quality improvement review board. When the quality improvement project is

approved by the review board, you can start collecting data and research to support your project.

Once all data is collected and reviewed, the board can approve the new best practice for

implementation. It is then the nursing managers job to educate the staff and monitor for

effectiveness of applying the preventative silicone foam. A good way to implement this

intervention is to apply Rogers’ theory of diffusion of innovations. This consists of four stages

that include knowledge, persuasion, adoption or rejection, and confirmation (Clark, 1995).

Applying these stages can help the nurses adapt to the new best patient care. In my facility,

nurses are encouraged to seek and apply evidence-based practice to provide the best patient care.

Literature to Support New Practice

When researching this new best practice, I have found a vast amount of literature to help

support my implementation. Utilizing the preventative silicone foam can significantly decrease

the risk of developing pressure ulcers in the ICU. One study showed that using the five-layered

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4 APPLYING NURSING RESEARCH TO PRACTICE

silicone foam versus traditional prevention methods significantly reduced the risk of developing

pressure ulcers by 88% (Kalowes, 2016). This method can be very cost effective and used with

traditional methods to decrease incidences of stage 3 and stage 4 pressure ulcers (Kalowes,

2016). Applying these foams to the sacral and heel areas in the emergency department led to a

significant reduction following the admission to the ICU (Santamaria et al., 2015). The

recommendation is to change the prevention foams every three days, or when soiled or dislodged

(Santamaria et al., 2015). The foams are to be on the patient throughout the entire ICU admission

to decrease the risk of pressure ulcer development. Examining the skin once a shift is a must to

determine the risk factors or developments of pressure ulcers (Santamaria et al., 2015). When the

silicone foam is applied it has shown to reduce the pressure load off the soft tissues and prevents

shearing from patient movement (Santamaria et al., 2015). During my literature review on

silicone foams, all evidence supports the use of foams and greatly benefits the patient. Nurses

need to monitor, assess, and utilize preventative silicone foams when deemed appropriate. It is

also important to still implement other pressure ulcer prevention measures as well.

In conclusion, recognizing an issue and providing a nursing unit with a new best practice

can help increase patient quality care. Nurses must recognize these issues and help seek and

develop new evidence-based practice in their units. Using the preventative silicone foams have

shown to greatly decrease pressure ulcer formation in ICU patients. Implementing this practice in

my unit can benefit the nurses and patients. Initiating the implementation appropriately following

my facilities policies and protocols is a must. After all is reviewed, educating about the new best

care can help the succession of the implementation of silicone foams.

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5 APPLYING NURSING RESEARCH TO PRACTICE

References

Clark, H. (1995, June). The Nightingale legacy. Paper presented at Child Health 2000.

International Pediatric Nursing Conference, Vancouver, B.C., Canada.

Retrieved from https://blackboard.ohio.edu/bbcswebdav/courses/NRSE_4550_10

33_SM _FALL_201718/CONTENT/MODULE_5/INSTRUCTIONAL_MATERIALS/REQUIR

ED_RESOUR CES/NRSE_4550_M5_IM_Using_Nursing_Research.pdf .

Kalowes, P. (2016). Five-layered soft silicone foam dressing to prevent pressure ulcers in the

intensive care unit. American Journal of Critical Care, 25(6), E108–E119. https://doi-

org.proxy.library.ohio.edu/10.4037/ajcc2016875

Kueny, A., Shever, L. L., Mackin, M. L., & Titler, M. G. (2015). Facilitating the implementation

of evidence-based practice through contextual support and nursing leadership. Journal of

healthcare leadership, 7, 29.

LoBiondo-Wood, G., & Haber, J. (2018). Nursing research: Methods and critical appraisal for

evidence-based practice (9th ed.). St. Louis, MO: Elsevier.

Santamaria, N., Gerdtz, M., Liu, W., Rakis, S., Sage, S., Ng, A. W., … Liew, D. (2015). Clinical

effectiveness of a silicone foam dressing for the prevention of heel pressure ulcers in

critically ill patients: Border II Trial. Journal of Wound Care, 24(8), 340–345. Retrieved

from https://search-ebscohost- com.proxy.library.ohio.edu/login.aspx?

direct=true&db=rzh&AN=109830221&site=ehost -live&scope=site.

This study source was downloaded by 100000822644233 from CourseHero.com on 06-08-2021 13:49:22 GMT -05:00

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6 APPLYING NURSING RESEARCH TO PRACTICE

This study source was downloaded by 100000822644233 from CourseHero.com on 06-08-2021 13:49:22 GMT -05:00

https://www.coursehero.com/file/41368353/Tester-Candice-M5-A10docx/

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