Question

2. You were the new registered nurse in a residential care home for the elderly (RCHE). You found that 20% of the clients were suffering from pressure injury. Currently, the Personal Care Workers (PCW) are responsible for basic care in the RCHE, existing Health Workers (HW) are working part time thus not overseeing the quality of care of PCW. You have to lower the pressure injury rate and you have done the following Fishbone diagram. Machine Human No pressure relieving device available Not enough PCW (80 residents 5 PCWs) High pressure injury rate No guideline on skin ba sic care PCW hasno knowledge in the best practice of continencecare, they change napkin in a mindlessway, they change napkin and tum client according to their own preference Method Discuss how you would apply Plan-Do-Study-Act cycle for one change you initiate. (15 marks)

Answer 1

As a registered nurse, one change i would like to initiate for lowering the pressure injury rate is to improve the knowledge of Personal Care Workers (PCW) in the best practice of continence care and provide them adequate training regarding this.

​​​​​I would apply Plan - Do - Study - Act cycle for this change which i would initiate. Plan - Do - Study - Act (PDSA) cycle is a four stage process which is used to carry out and implement any change. It is used to achieve improvement in any ongoing process. In order to initiate and implement my change for lowering the pressure injury rate, Plan - Do - Study - Act (PDSA) cycle can be applied in the following way :-

• Plan : In this stage, i would state my objectives regarding improving the knowledge of Personal care workers (PCW) in the best practice of continence care for lowering the pressure injury rate. I would develop my plan to achieve my objectives and carry out rest cycle.
• Do : In this stage, i would carry out all tests, analysis, and unexpected observations regarding lack of knowledge of PCWs and their adequate training.
• Study : In this stage, i would summarize all what i have observed and learned about the problem.
• Act : In this stage, i would determine what changes are to be made and what steps are to be taken to achieve my goal. In this stage, i would implement all the necessary steps for improving the knowledge of PCWs and provide them adequate training regarding the continence care.

This is how, i would apply Plan - Do - Study - Act cycle to initiate and implement my change.