Clinical Activity: Obstacles

Clinical Activity: Obstacles

The practicum project, dedicated to the prevention of pressure ulcer occurrence in patients at Intermediate Care Unit in Kendall Regional Medical Center, outlined the nature of the problem and presented the changes necessary to implement for the purpose of pressure ulcers prevention. The project justifies the necessity to implement the changes. Pressure ulcers occurrence results in prolonged hospital stays, and increased healthcare expenses. The lack of the necessary nurses training, as well as the inefficiency of assessment scales, is identified as the major problem. The purpose of this paper is to identify the nonhuman obstacles to the introduction of the necessary changes, and devising a plan to overcome them.


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Nonhuman Obstacles

The changes, outlined in the practicum project, include upgrading the nurses’ knowledge on the matter, while improving their skills regarding pressure ulcer prevention, and decreasing the number of pressure ulcer occurrences in a period of six months. The obstacles of nonhuman character that might hinder the process of implementation may include the lack of sufficient resources, entailing the lack of equipment indispensable for prevention of ulcer occurrence, and the hospital policy, which might create obstacles for ensuring the adequate nurses staffing level.

The first nonhuman obstacle, i.e. the lack of resources, is a major concern for the majority of healthcare providers. Insufficient funding is a significant impediment for providing the necessary medical services. The equipment needed for pressure ulcer prevention includes various support systems, such as static mattresses, and overlays, as well as chair cushions, or heel supports (Chou et al., 2013, p. 31).

Another nonhuman obstacle stems from the hospital policy, which might be reluctant to ensure the necessary nurses staffing level. The inadequate nurse-to-patient ratio is a serious problem for the implementation of the necessary changes. Even with the education provided, the nurses would not be able to apply their recently acquired skills and gained knowledge due to the insufficient amount of time per patient. Thus, low staffing level constitutes a major obstacle for the project.

Overcoming the Obstacles

The lack of resources and, therefore, the lack of the necessary pressure reducing equipment can be a major hindrance to the implementation of changes. Provision of repositioning equipment, especially of active surface systems, is of utmost importance for the ulcer prevention purposes (Sibbald, Goodman, Norton, Krasner, and Ayello, 2012, p. 4). In order to resolve this problem, it is crucial to devise a project, justifying the purchase of the equipment, emphasizing the benefits of its use for the patients, as well as for the hospital. Certain studies show that improved prevention measures lead to substantial savings (Leaf Healthcare, Inc., 2014, p. 3). It is necessary to provide the administration with the recent data, proving the cost-effectiveness of the proposed solution, in order to secure the provision of equipment.

The second nonhuman obstacle, pertaining to the nurses staffing levels, is a pressing matter as well. A joint staff effort is needed to devise and perform a decisive, determined campaign, aimed at changing the hospital policy in terms of nurses staffing. Such a project must clearly identify the problem, outline its negative influence on the patient outcomes, and present the advantages of improved situation. Even with the right equipment, nurses might not have the time needed for a thorough skin assessment. According to Berlowitz et al. (2014), the lack of time is a significant hurdle on the way to improved preventive health care (p. 41).


The implementation of the project change faces certain difficulties, including nonhuman obstacles. It is undeniable that the presented methods of pressure ulcer prevention will lead to improved patient care, higher patient satisfaction, and substantial savings. The obstacles outlined above can be managed by a carefully planned campaign, capturing the attention of the administration, and convincing it to invest in the long-term improvement plan.


Berlowitz, D., VanDeusen Lukas, C., Parker, V., Niederhauser, A., Silver, J., Logan, C., Ayello, E., & Zulkowski, K. (2014). Preventing pressure ulcers in hospitals. A toolkit for improving quality of care. Web.

Chou, R., Dana, T., Bougatsos, C., Blazina, I., Starmer, A. J., Reitel, K., & Buckley, D. I. (2013). Pressure ulcer risk assessment and prevention: a systematic comparative effectiveness review. Annals of Internal Medicine159(1), 28-38.

Leaf Healthcare, Inc. (2014). The financial impact of pressure ulcers. Web.

Sibbald, R. G., Goodman, L., Norton, L., Krasner, D. L., & Ayello, E. A. (2012). Prevention and treatment of pressure ulcers. Skin Therapy Letter17(8), 4-7.


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