The intervention that will be implemented to address the clinical nursing practice problem.

Full Answer Section

The Intervention: A Multi-faceted HAPI Prevention Bundle Implementation with Enhanced Education and Auditing

The intervention designed to address this problem is a comprehensive, multi-faceted approach centered around the implementation of a standardized HAPI Prevention Bundle, reinforced by enhanced, ongoing education and a robust system of auditing with timely feedback. This intervention draws upon principles of evidence-based practice, change management, and continuous quality improvement.

Components of the Intervention:

1. Standardized HAPI Prevention Bundle Development and Integration:

   • What: A concise, evidence-based bundle will be developed, integrating the core elements of pressure injury prevention. This typically includes:
     • Head-to-toe skin assessment daily (including skin of color variations).
     • Activity and mobility assessment with frequent repositioning schedule (e.g., Q2H turning with documentation, use of 30-degree lateral incline).
     • Perfusion and nutrition optimization (e.g., hydration, dietary consult for at-risk patients).
     • Incontinence and moisture management (e.g., use of barrier creams, timely cleansing).
     • Support surface selection (e.g., appropriate mattress/cushion based on risk).
   • How it addresses the problem: This bundle provides a clear, actionable checklist, reducing variability in practice and ensuring that essential interventions are consistently applied for every at-risk patient. It simplifies complex guidelines into a manageable set of actions. The standardized documentation within the EHR will prompt nurses to complete each element.

2. Enhanced Education and Competency Validation:

   • What: Mandatory, interactive education sessions will be provided to all nursing staff (new hires and current employees) covering the rationale behind each bundle element, proper techniques (e.g., precise repositioning, skin assessment for diverse skin tones, correct application of support surfaces), and effective documentation. This will include hands-on practice and scenarios.
   • How it addresses the problem: Addressing potential knowledge gaps and skill deficits directly. By ensuring all staff understand why each step is crucial and how to perform it correctly, it builds confidence and promotes adherence. Competency validation (e.g., return demonstrations, online modules with quizzes) ensures understanding and skill mastery.

3. HAPI Nurse Champions Program:

   • What: Identify and train a cohort of highly motivated and skilled staff nurses from each unit to become "HAPI Champions." These champions will serve as unit-level resources, mentors, and advocates for the prevention bundle, providing informal peer education and support.
   • How it addresses the problem: Champions foster a culture of prevention from within. They can provide immediate, point-of-care feedback, address questions, and reinforce best practices, acting as crucial peer influencers who normalize and champion consistent adherence.

4. Regular Auditing with Timely, Constructive Feedback:

   • What: A systematic process for regular audits will be established. This includes:
     • Process Audits: Random audits of patient charts to confirm bundle adherence (e.g., repositioning documented every 2 hours, Braden Scale completed, barrier cream noted). Direct observation of care practices.
     • Outcome Audits: Tracking unit-specific HAPI incidence rates.
     • Feedback: Weekly or bi-weekly meetings with unit leadership and staff to share audit results (both positive trends and areas for improvement) in a non-punitive, educational manner. Celebrate successes and identify collective challenges.
   • How it addresses the problem: This is crucial for driving behavioral change and sustaining the intervention. Auditing provides accountability and highlights areas where adherence is strong or weak. Timely, constructive feedback allows nurses to understand their performance, learn from mistakes, and adjust their practice. Seeing positive trends in HAPI rates also reinforces the impact of their efforts, boosting morale and commitment.

Implementation Plan (Overview):

• Phase 1 (Month 1): Planning & Protocol Development: Establish a multidisciplinary HAPI Prevention Task Force (nursing leadership, wound care specialist, informaticist), review current HAPI rates, update/create bundle protocols, develop educational materials, identify and train HAPI Champions.
• Phase 2 (Month 2-3): Education & Initial Rollout: Conduct mandatory education sessions for all staff. Launch the HAPI Prevention Bundle and new documentation processes. Champions provide initial unit-level support.
• Phase 3 (Month 4-6): Monitoring & Adjustment: Begin regular process and outcome audits. Implement structured feedback sessions. The task force meets regularly to review data, identify barriers, and make necessary adjustments to the bundle or education.
• Phase 4 (Ongoing): Sustainment: Integrate HAPI prevention into new employee orientation. Continue periodic audits and feedback. Acknowledge and reward high-performing units/individuals. Ensure ongoing access to resources and support surfaces.

Anticipated Outcomes:

• Primary Outcome: A measurable decrease (e.g., 25% reduction within 6 months, 50% within 12 months) in the incidence of Hospital-Acquired Pressure Injuries on targeted units, bringing rates below national benchmarks.
• Secondary Outcomes:
  • Increased adherence to the HAPI Prevention Bundle elements by nursing staff.
  • Improved nurse knowledge and confidence in pressure injury prevention.
  • Reduced patient pain and discomfort associated with pressure injuries.
  • Decreased healthcare costs related to HAPI treatment and extended stays.
  • Improved patient and family satisfaction with care.
  • Enhanced unit and organizational quality metrics and reputation.

By systematically implementing this multi-faceted intervention, the organization aims to standardize best practices, empower nursing staff with knowledge and support, and continuously monitor progress, ultimately leading to a significant reduction in HAPIs and a safer, higher-quality care environment for patients.

Sample Answer

Let's consider a common clinical nursing practice problem: Inconsistent adherence to evidence-based protocols for preventing Hospital-Acquired Pressure Injuries (HAPIs) among nursing staff, leading to a higher-than-benchmark incidence rate.

This problem directly impacts patient safety, quality of care, patient satisfaction, and healthcare costs. HAPIs can cause significant pain, prolonged hospital stays, infections, and even mortality. The core issue is often a gap between knowing what to do (evidence-based guidelines exist) and consistently doing it in practice due to various factors like workload, knowledge deficits, or lack of standardized processes.