Reflective Improvement Plan for Pressure Injuries at the Sacrum and Heel (Stage 2)

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Reflective Improvement Plan for Pressure Injuries at the Sacrum and Heel (Stage 2)
Pressure injuries, commonly known as pressure ulcers or bedsores, are a significant healthcare concern, especially for people with limited mobility (Gefen et al., 2022). A healthcare professional must continuously reflect on practice and identify areas for improvement in pressure injury prevention and management (Jiang et al., 2020; Padula & Delarmente, 2019). This reflective improvement plan will utilize Gibbs’ Reflective Cycle to explore a recent experience with a patient who developed pressure injuries at the sacrum and heel (Stage 2). The plan will detail the six stages of the reflective cycle, focusing on creating actionable strategies for improvement.
Description
The initial stage of the reflective cycle involves describing the situation. In this case, the patient presented with pressure injuries at the sacrum and heel, classified as Stage 2 according to the National Pressure Injury Advisory Panel (NPIAP) guidelines. Stage 2 pressure injuries are characterized by partial-thickness skin loss, which may appear as an open ulcer, blister, or shallow crater (Med Law, 2016). The affected area presents as a shallow wound with a defined border, typically involving the epidermis and sometimes extending into the dermis. The wound bed may be pink or red, and there may be fluid-filled blisters. The sacrum is the triangle bone at the base of the spine, placed between the two hip bones, whereas the heel is the back portion of the foot (Marshall et al., 2019). These areas are particularly susceptible to pressure injuries due to their anatomical structure and the constant pressure they endure when a person remains seated or lying for extended periods. Pressure injuries occur when continuous pressure or friction against the skin impairs blood flow to the affected area, leading to tissue damage and subsequent breakdown. The patient had limited mobility and required assistance with repositioning (Amirah et al., 2019; Casal-Guisande et al., 2020; Ebi et al., 2019; Gaspar et al., 2019; Gillespie et al., 2020; Hahnel et al., 2020; Lin et al., 2022).
Feelings
The feelings stage involves exploring personal emotions and reactions. The healthcare provider experienced various emotions, including concern and empathy for the patient. Pressure injuries can cause significant pain, discomfort, and potential complications, which trigger the empathetic response. Furthermore, the healthcare provider felt a sense of responsibility to improve knowledge and skills in preventing and managing pressure injuries.
Evaluation
The evaluation stage critically analyzes the situation and identifies strengths and weaknesses. Upon reflection, it became evident that several areas required improvement. Firstly, there needed to be an adequate risk assessment for pressure injuries. This oversight led to insufficient preventive measures being implemented. Secondly, the healthcare provider realized that understanding proper repositioning techniques needed to be more comprehensive and failed to prioritize frequent skin inspections. Lastly, more patient education should be provided regarding pressure injury prevention and self-care.
Analysis
A deeper examination of the factors contributing to pressure injuries is conducted in the analysis stage. Firstly, inadequate risk assessment can be attributed to a need for more awareness of the various risk factors, such as immobility, poor nutrition, and incontinence. Secondly, insufficient knowledge of effective repositioning techniques and the importance of pressure redistribution resulted in prolonged pressure and shear forces on vulnerable areas. Additionally, the lack of emphasis on frequent skin inspections hindered the early detection of skin changes. Lastly, inadequate patient education on pressure injury prevention and self-care limited patients' ability to participate actively in their care.
Conclusion
The conclusion stage involves summarizing the insights gained through reflection. Continuous learning and improvement in pressure injury prevention and management are essential in this case. There is an opportunity to enhance patient outcomes, minimize the occurrence and severity of pressure injuries, and improve the overall quality of care by addressing the identified issues,
Action Plan
The action plan stage focuses on developing concrete strategies for improvement. The following actions will be undertaken to address the identified areas of improvement:
Knowledge Enhancement
A comprehensive approach will be taken to enhance knowledge:
* Review the latest evidence-based guidelines, research articles, and clinical practice recommendations on pressure injury prevention and management from reputable sources such as professional journals, clinical organizations, and government agencies (Ayello et al., 2019). It will ensure that the most up-to-date information is incorporated into practice.
* Attend workshops, conferences, webinars, or continuing education courses on pressure injury prevention and management. These educational opportunities will provide access to experts in the field, foster interactive learning experiences, and promote the application of evidence-based practices.
* Subscribe to relevant professional journals, newsletters, and online resources to stay informed about the latest advancements, research findings, and best practices in pressure injury prevention and management. This ongoing access to new information will support continuous learning and keep knowledge current.
Collaborative Learning
The following strategies will be implemented to leverage the benefits of collaborative learning:
* Actively participate in multidisciplinary team meetings dedicated to pressure injury prevention and management. It will involve engaging in discussions, sharing experiences, and contributing to problem-solving initiatives. By collaborating with professionals from different disciplines, diverse perspectives can be gained, leading to a holistic understanding of the subject matter (Schot et al., 2020).
* Initiate case reviews with colleagues to explore past experiences and learn from successful and challenging cases. These sessions will provide an opportunity to reflect on decision-making processes, identify areas for improvement, and share best practices.
* Participate in peer-to-peer learning sessions, such as journal clubs or presentations, where healthcare professionals can share and discuss relevant research articles, case studies, or innovative approaches. This collaborative approach allows for knowledge exchange and exploring different viewpoints (Gruppen et al., 2019).
* Join professional networks, communities, or online forums for pressure injury prevention and management. These platforms provide opportunities to connect with experts and peers in the field, engage in discussions, ask questions, and share insights and resources. Active participation in these communities promotes collaborative problem-solving and continuous learning (Wilson et al., 2023).
Skills Practice
The following actions will be taken to enhance skills in pressure injury prevention and management:
* Practice proper repositioning techniques that ensure adequate pressure redistribution and shear reduction (Ippolito et al., 2022; Li et al., 2022; Ozcan & Karaali, 2022; Pacific, 2019; Prakash & Prakash, 2019). It will involve learning different repositioning methods, understanding the principles of pressure redistribution, and utilizing appropriate equipment, such as pressure-relieving cushions or mattresses.
* Conduct regular and thorough skin assessments to detect early signs of pressure injuries (Pacific, 2019). It will involve developing proficiency in skin inspection techniques, identifying risk factors, and understanding the characteristics of different stages of pressure injuries.
* Seek opportunities for hands-on training, workshops, or simulations to practice skills related to pressure injury prevention and management. These practical experiences will allow for applying theoretical knowledge in a controlled environment and provide valuable feedback for improvement.
Patient Education
The following strategies will be implemented to improve patient education on pressure injury prevention and self-care:
* Create instructional materials and tools suited to patients' requirements and learning styles. It may include brochures, pamphlets, infographics, or videos that explain pressure injury prevention, proper repositioning techniques, and the importance of regular skin inspections (Team et al., 2020).
* Conduct one-on-one educational sessions with patients and their caregivers to provide personalized education on pressure injury prevention and management (Gupta et al., 2020). These sessions will empower patients to actively participate in their care, including teaching them how to perform self-assessments, recognize early signs of pressure injuries, and report any changes promptly.
* Utilize visual aids, demonstrations, and interactive techniques during educational sessions to enhance understanding and retention of information. Encouragement of patients and caregivers to ask questions and clear instructions and written materials for reference will reinforce learning and enhance compliance (Turabian & Turabian, 2019).
Documentation and Evaluation
The procedures outlined will be done to guarantee accountability and progress monitoring:
* Consistently document assessments, interventions, and outcomes for preventing and managing pressure injuries. It includes mainta...