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Systemwide Practice Change Program to Combat Hospital-Acquired Pressure Injuries: Translating Knowledge Into Practice
Michelle Barakat-Johnson1, Michelle Lai, Timothy Wand
1Sydney Local Health District, Camperdown, Sydney, Australia (Ms Barakat-Johnson and Drs Wand and White); Faculty of Medicine and Health, Susan Wakil School of Nursing, University of Sydney, Camperdown, Sydney, Australia (Mss Barakat-Johnson and Lai and Drs Wand and White); Emergency Department, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, Australia (Dr Wand); and School of Nursing, Queensland University of Technology and Intensive Care Services, Royal Brisbane and Women's Hospital, Kelvin Grove, Queensland, Australia, and Institute for Skin Integrity and Infection Prevention, University of Huddersfield, UK (Dr Coyer).
Background:
Considerable evidence exists on how to prevent hospital-acquired pressure injuries (HAPIs). However, processes employed to implement evidence play a significant role in influencing outcomes.
Problem:
One Australian health district experienced a substantial increase in HAPIs over a 5-year period (by almost 60%) that required a systemwide practice change.
Approach:
This article reports on the people, processes, and learnings from using the Promoting Action on Research Implementation in Health Services (PARiHS) framework taking into account the evidence, context, and facilitation to address HAPIs.
Outcomes:
Applying this approach resulted in a significant decrease in pressure injuries and positive practice change, leading to improved patient outcomes in a shorter time frame than previous strategies.
Conclusion:
Processes guided by the PARiHS enhanced the effectiveness of translating evidence into practice and positively assisted clinicians to promote optimal patient care. This approach is transferrable to other health care settings.
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