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Continuous Lateral Rotation Therapy Training to Promote Adherence to Evidence-based Practice Guideline in a Medical Intensive Care Unit368 views
Author
McGraw-Schenck, Tamela, Nursing Practice - School of Nursing, University of Virginia0000-0003-3624-9847
Advisors
Quatrara, Beth, NR-Nursing: Faculty, University of Virginia
Abstract
Background: Patients who experience immobility in a critical care setting are at risk of developing skin breakdown. Hospital-acquired pressure injuries (HAPI) contribute to health care problems worldwide. Literature supports continuous lateral rotation therapy (CLRT) that redistributes pressure as an efficient means to reduce HAPI and provide mobility for patients who are critically ill or have unstable conditions. Purpose: The purpose of this project was to promote the registered nurse (RNs) and patient care technician’s (PCTs) adherence to evidence-based practice (EBP) through training of continuous lateral rotation therapy (CLRT) in the medical intensive care unit (MICU). Method: A hands-on, educational intervention was conducted in the MICU of an academic medical center. Effectiveness was evaluated in a quantitative pre and post evaluation. Results: Sixty-seven nursing staff participated in the project. Results showed a positive trend toward increased adherence in CLRT initiation, the mode used during therapy, or maintaining every 2-hour turn regimen pre and post-training. Statistical significance was noted in staff confidence level (p <.000), in using CLRT in current practice for patients who could not be turned due to hemodynamic instability (p <.000), and staff experience with implementing or preparing the bed for CLRT use (p<.005). In reviewing post-training data from the EHR, none of the patients who met inclusion criteria and received CLRT were noted to have documentation indicating the presence of HAPI.
Conclusion: EBP education and hands-on training may contribute to increased staff adherence to new practices that involve new technologies. EBP education and clinical application of CLRT could leverage the nurse to optimize the quality of care.
Keywords: ("continuous lateral rotation" OR "kinetic therapy") AND ("hospital-acquired pressure ulcer" OR "hospital-acquired pressure injury" OR pressure ulcer) AND ICU.
McGraw-Schenck, Tamela. Continuous Lateral Rotation Therapy Training to Promote Adherence to Evidence-based Practice Guideline in a Medical Intensive Care Unit. University of Virginia, Nursing Practice - School of Nursing, DNP (Doctor of Nursing Practice), 2020-04-22, https://doi.org/10.18130/v3-ba9f-eh40.