CNA803: Advanced Clinical Nursing - Practice Change Proposal

Assignment Task

Introduction

This practice change proposal aims to reduce the number of identified pressure area injuries associated with cervical collar placement on trauma patients. This proposal outlines an early intervention plan to monitor and identifying any deterioration in skin quality. The purpose is to prevent pressure areas from occurring, facilitate early recognition of deterioration and promote safe practice, thereby improving quality of care provision and patient outcomes.

A literature review will offer background evidence for this proposed practice change need as well as information on the associated financial cost and resources required. The implementation efficacy will be discussed and a method of project performance evaluation put forward. On conclusion, this small, simple innovative change will be proven to increase care quality on trauma wards.

Background

Delivery of safe, quality care implies the provision of the most suitable, best value care while simultaneously preventing harm (Australian Institute of Health and Welfare (AIHW) 2020). Braithwaite (2018) identified that historically 10% of admitted patients encountered adverse events with more recent statistics demonstrating that over 7.89% of 2019-20 admissions experienced a hospital-acquired complication (AIHW 2021).

Project aim and objectives

The aim of this is to promote patient centred care through appropriate improved care delivery that is financially sustainable by listening to consumer needs, investigating and providing positive patient outcomes. This will be achieved by ensuring that all patients wearing cervical collars undergo documented skin assessment in the acute setting to prevent dermal deterioration and allow early recognition of PI thereby reducing morbidity and mortality. This aim aligns with the NSW state health plan – towards 2021 (NSW Government: Health 2014) and is supported by the Healthshare NSW Strategic Plan 2020-2024 (Healthshare NSW 2020) which focuses on consumers, staff, sustainability and collaboration.

The primary objective of this project is to reduce PIs development risk as a direct result of collar placement through a collar care plan (CCP) which entails skin assessment, documentation of skin change, and care initiated with outcomes evaluated. Secondary objectives include a reduction in monetary resources regarding cost of dressings associated with PI, nurse time associated with facilitating dressing changes, and decreased pain felt by patients.

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