1. The decubitus ulcer : also known as pressure ulcer or bed sore refers to an open wound found on the surface of the skin. Decubitus ulcer is often found on the skin that covers bony areas especially on the hips and at the back (Walsh et al., 148). Mepilex : is a dressing form that is used to dress various wounds.
Above are the definitions of Decubitus Ulcers and Mepilex dressing as a method of treating and controlling the disease.
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2. Advantages of Mepilex Minimizes pain when dressing changes
Effectively exudate management Reduces the risk of macerationIt is soft and Conformable
Above are the various advantages of Mepilex
Myth 1: Dressing meant for open used is not suitable for DU preventionTruth: A variety of dressings including foams, hydrocolloids and films can be prevent DU
Myth 2: When Dressing is used, no other DU preventive method can be usedTruth: Standard DU prevention measures can be continued even after dressing has been used (Carter et al., 25)
Myth 3: Dressings are so thin such that they cannot prevent the causative agents of DU
Truth: Dressings can reduce friction, redistribute shear and prevent over-hydrationAbove are various myths about using dressing to treat and control Decubitus Ulcers
Myth 4: A dressing should be left undisturbed until the next time for change
Truth: A dressing can be used for several days though a physician inspects the dressing from time to time.
Set up a health facility with all the necessary healthcare providers and tools to prevent and treat Decubitus ulcer with the use of Mepilex dressing
Risk Assessment: The healthcare team will be educated on how to use each tool and the basics in Decubitus ulcers related issues
Skin Assessment: Before Mepilex dressing is carried out, the skin of the patients will be assessed to determine skin moisture content, the condition of the skin and extent of damage. Practical precaution measures will be initiated whenever needed.
Nutritional support: The facility will have a nutritionist who will advise the patients on the recommended foods and also check the hydration status of the patients
Repositioning: Healthcare providers will ensure that repositioning will be carried out in a manner that prevents shear or friction forces. A 30-degree tilted side lying position will be used.
Support surfaces: Patients will be engaged so as to determine the most suitable devices to be used. For example, the patient may require a certain positioning of the pillows.
Specialist Groups: The facility will link the patients with various specialised groups where the patients can get various supports. Above are the various goals set for the project.
The effectiveness of the facility in terms of cost, time and resources
How effective the method is in curing the diseaseWhether the patients are contented with the services offeredHow successful the disease was cured without re-emerging after some time.
Above are the various ways we shall determine if our goals are achieved or not.
Infrastructure and Interior Design Cost Program Expenses Budget Amount Rental Fees $600,000 Processing of Legal Documents $150,000 Furnishes of all buildings $300,000 Interior Design to Suite the Legal Requirements $150,000 Security Features $85,000 Lighting, Sewage and Water Connection Expenses $300,000 Total ? $1,585,000
The various expenses that will be spent in infrastructure and interior design of the facility8 Description Cost Mepilex Border $ 12,000 Gloves $120 Cotton wool $50 Trolley $600 Cleaning Detergents $200 Water distiller $2400 Examination lamp $3000 Diagnostic set $5,000 Stethoscope $4,000 Drug cabinet $307,000 Thermometer $200 Weighing scale adult $240 Screen bed $1200 Total $336,010
Above are the estimated costs for various tools and equipment that the facility will require9Cost on Staff Position Annual Salary Total Clinical Superintendent 85,000 85,000 Clinical Supervisor 73,400 220,220 Medical Physician 187,200 (3) 371,600 Physician Assistant 98,200 294,600 Pharmacist 121,500 243,000 Chief Financial Officer 95,000 95,000 Sales Representative 102,200 102,200 Administrative Assistant 40,600 40,600 Human Resource Manager 63,700 63,700 Security Guards 28,400 (4) 113,600 Record Keeper 34,600(2) 69,200 Total $1,698,720The estimated annual cost on staff is as shown above
Agreements and contracts 3 months Place orders for equipment 3 months Determine opening date 3 months File necessary regulatory forms and documents 3 months NM/BMT start working on the new facility 2 months Finalize number of workers and staff needed/ hire the staff 2 months.
The timetable of events before the operations start11 Task Timeline Order signage 2 months Setup medicine accounts 2 months Establish continuous quality improvement(CQI) 2 months Order long distance services 6 weeks Coordinate installation of equipment 6 weeks Verify installation of equipment/furniture 6 weeks Count inventory and place reorder 6 weeks.
Task Timeline Inform patients transferring from other facilities 1 month Purchase office supplies 1 month Negotiate line/laundry service 1 month Purchase housekeeping supplies 2 weeks Setup emergency services 2 weeks Schedule patients on the dressing rooms 1 week Work on patient/staff schedules 1 week.
Questionnaires: Open and closed questionnaires will be distributed to patients and healthcare professionals who treat decubitus ulcerResearch: Government records, internet sources and credible medical documents will be reviewed
Interviews: Various Health care providers and leaders will be interviewed and their ideas recorded.
The various data collection mechanisms in the project are shown above.
Change and leadership theories to ensure success
Model of Change (Kotter)
Create the need for an urgent changeBuild a coalition Form strategic initiatives and visionThe most suitable model of change is shown above which is the Kotter model.
Communicate the vision to people
Remove barriers to enable actionIdentiy short-term winsImplementing and sustaining
Sustain the winsInstitute change (Kuo et al., 3204 )
ConclusionThe above slides describe the planning and implementation stages of the project of treatment and prevention of decubitus ulcer by the use of Mepilex dressing.
The goals of the project have been identified and described. Also, the resources that are required for the project have been identified and considered the change management measures. A detailed project plan has been outlined. The plan’s resources have been outlined and the time schedule for various activities identified. The most suitable change and leadership theory for the project has also been described. Conclusion of the project highlighting various aspects of the project.
Carter MJ. Cost-effectiveness research in wound care: definitions, approaches and limitations. Ostomy Wound Manage 2012″ ” 56(11): 22-33.
Kuo CY, Wootten CT, Tylor DA, et al. Prevention of pressure ulcers after pediatric tracheotomy using a Mepilex Ag dressing. Laryngoscope 2013″” 123: 3201-5.
Walsh NS. Blanck AW, Smith L, et al. Use of a sacral silicone border foam dressing as one component of a pressure ulcer prevention program in an intensive care unit setting. J Wound Ostomy Continence Nurs 2012″ 39(2): 146-49.18
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