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write a conclusion that includes the following: re-state your PICO question and briefly summarize what you have learned through your search. Discuss whether your question was completely answered or not. What would you recommend, if anything, as a change in practice for nurses? Why? Remember, this is your closing paragraph(s). This paragraph should include information from each of your sources. Therefore you should also cite all of your sources in this paragraph. Also be sure to include recommendations for practice based on what you learned from your four sources. My paper is as follows: Effect of Nursing Interventions on Pressure Injury Prevention in Hospitalized Adults Michelle Cupp College of Nursing and Health Innovation, University of Texas at Arlington NURS 4325: Nursing Research Regina Urban, PhD, RN, NPD-BC, CNE, ACUE, MA-LPC March 15, 2025 Effect of Nursing Interventions on Pressure Injury Prevention in Hospitalized Adults Pressure injuries have a significant impact on patient outcomes and are detrimental in preventing in patients who are at high risk of developing in the hospital setting. The PICO question related to this issue is: In adult patients in acute inpatient care, do nursing interventions for pressure injury prevention reduce the incidence of pressure injuries compared to standard care during hospitalization? Nursing interventions are detrimental in reducing the incidence of pressure injuries in patients as nurses are providing care 24/7 while in the hospital setting. If nurses do not practice pressure ulcer prevention strategies, this results in poor patient outcomes, increased hospital cost, and increased instances of mortality and morbidity. For instance research by Sim et al. (2024), found 4.09% more likely that a patient will die if they get a Stage 1 pressure injury in the hospital than if they don’t get one. For someone who has an Unstageable pressure injury, the risk of death rises to 6.67 times higher. Financial burden is considerable, with the cost of pressure injuries in Australia reaching 5.1 billion dollars, all of which could be avoided through effective nursing interventions also researched by Sim et al. (20240. Pressure injuries are an expensive preventable diagnosis that nurses are able to prevent with providing care to reduce the risk of pressure injuries to improve patient outcomes and reduce the outrageous cost of pressure injury treatments. Summary of Research Article The article provided valuable insights that educating our nursing staff of the importance of implementing pressure ulcer prevention strategies is detrimental. If nurses are not adequately educated on the importance of pressure ulcer prevention in improving patient outcomes and the risks of pressure injuries, why would they prioritize preventive measures in their daily care? Tervo-Heikkinen et al. (2023) conducted a descriptive study using a convenience sample from 16 acute inpatient care settings across Finland. Tervo-Heikkinen et al. (2023) found that the malnutrition risk assessments were not adequately conducted on all participants in the study with a risk of developing a pressure injury. However, they found that malnutrition screening, as part of a comprehensive care bundle, has been proven effective in preventing pressure injuries (PIs) through its role in preventive care. Another major finding researched by Tervo-Heikkinen et al. (2023) was that preventive interventions were mostly focused on patients that currently had pressure injuries instead of patients that are at high risk, showing that prevention efforts were reactive instead of proactive. This highlights the need for early risk assessments and interventions to prevent pressure injuries effectively. Major Variables There article researched several different research variables effective in preventing pressure injuries in hospitalized patients. One variable mentioned by Tervo-Heikkinen et al. (2023), was the pressure injury risk assessment, which refers to the chances of a patient developing pressure injuries due to factors like limited mobility and poor nutrition. The pressure injury risk assessment was measured using tools like the Braden Scale within 8 hours of admission as the operational definition of this variable. Another variable researched by Tervo-Heikkinen et al. (2023), was the skin status assessment, which checks the condition of the skin in areas more likely to develop pressure injuries and was performed by bedside nurses through a thorough skin assessment within 8 hours of admission which is the operational definition and documented in medical records. Preventive nursing interventions was another variable discussed by Tervo-Heikkinen et al. (2023) in the article, such as repositioning, different support surfaces, and skin care. The operational definition for preventative nursing interventions is the nursing documentation of the intervention and frequency of the intervention being provided. Tervo-Heikkinen et al. (2023) found that malnutrition risk, which refers to the likelihood of a patient being malnourished and increased patients for delayed/poor wound healing, was measured using tools like the Nutrition Risk Screening 2002 as the operational definition. In this study, malnutrition risk and preventive interventions are independent variables, while pressure injury development is the dependent variable. Strengths and Weaknesses The strengths of the research article by Tervo-Heikkinen et al. (2023) that was observed in this study was the size of the study conducted and the use of reliable measurable tools such as the Braden risk assessment and Norton Scale. There were several weaknesses observed in this article. A weakness that stuck out was the pressure injury interventions were not utilized on all the patients consistently and they were unable to accurately provide results if the interventions were successful. Such as, nurse managers reported the malnutrition screening was being utilized on 70% of the patients when in reality, only a fifth of the patients had the malnutrition screening conducted. Another weakness was that the different hospitals in the study were not using the same methods to collect data for this study and the nurses were not assessed on accuracy of staging pressure ulcers which could lead to inaccurate data regarding the stages of pressure injuries. Practice Guideline The name of the clinical practice guideline is “Prevention and treatment of pressure ulcers/injuries: quick reference guide.” by (National Pressure Injury Advisory Panel, n.d.). The organization that sponsored the guideline is the National Pressure Injury Advisory Panel. First, the clinical practice guideline recommends completing a nutritional risk assessment on all patients with increased risk of pressure injuries (National Pressure Injury Advisory Panel, n.d.). When nurses identify patients at risk of pressure injuries this allows physicians, nutritionists, and nurses to work together to help provide the patient with adequate nutritional requirements to help reduce skin breakdown. Additionally, the guidelines confirm the importance of regular repositioning of patients to prevent the skin from breaking down at least every two hours (National Pressure Injury Advisory Panel, n.d.). Finally, the use of different support surfaces is also recommended in the article for best practices to reduce skin breakdown in patients (National Pressure Injury Advisory Panel, n.d.). Fourth Resource The other research article utilized by another discipline is “The Role of Physical and Occupational Therapy in Pressure Injury Prevention” by Slayton et al. (2020). Physical and Occupational therapists play a pivotal role in helping nursing reduce the risk of pressure injuries in patients. Therapists are able to help nursing identify patients at risk and help collaborate with the appropriate care team to provide an individualized care plan for patients. One important finding from Slayton et al. (2020) is that therapists can contribute to reduce the risk of patients developing pressure injuries by assessing the patient’s mobility levels and providing patients with the appropriate equipment and education on how to properly use equipment. Additionally, as described by Slayton et al. (2020) therapists are able provide patients with exercise plans to increase their strength and improve the risk of patients becoming immobile which increases the risk of developing a pressure injury. Utilizing Physical and Occupational therapists early during their hospital stays allows them to develop plans to decrease their risk of becoming weak and losing their ability to mobilize. Also, it helps identify the patients that are at increased risk due to weakness and therapists can provide an action plan early on during their hospital stay. Lastly, Slayton et al. (2020) determined that therapists can assist nursing in the nutrition assessment for patients. Consulting therapists, they can assess if the patient may require support or specialized equipment to facilitate eating and drinking. In nursing we assess the patient for malnutrition, increasing the risk of pressure injuries and recommend supplements. As nurses it is pivotal to collaborate with our peers to reduce the risk of pressure injuries in hospitalized patients. Conclusion References National Pressure Injury Advisory Panemalnutrition,,,,revention and treatment of pressure ulcers/injuries: quick reference guide. https://internationalguideline.com Sim, J., Wilson, V., & Tuqiri, K. (2024). The pressure injury prevalence and practice improvements (pippi) study: A multiple methods evaluation of pressure injury prevention practices in an acute‐care hospital. International Wound Journal, 21(10). https://doi.org/10.1111/iwj.70050 Slayton, S., Deppisch, M., Kennepp, L., Parent-Lew, S., Samson, B., & Thurman, K. (2020). The role of physical and occupational therapy in pressure injury prevention. Journal of Acute Care Physical Therapy, 12(3), 98-114. https://doi.org/10.1097/jat.0000000000000154 Tervo-Heikkinen, T., Heikkilä, A., Koivunen, M., Kortteisto, T., Peltokoski, J., Salmela, S., Sankelo, M., Ylitörmänen, T., & Junttila, K. (2023). Nursing interventions in preventing pressure injuries in acute inpatient care: A cross-sectional national study. BMC Nursing, 22(1). https://doi.org/10.1186/s12912-023-01369-8

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