To successfully implement a change within an organization, the change agent must assess the organization’s culture and readiness for change

Important:

· This course is based on the previous course and the topics we covered. You
MUST read and understand the topic that we will be writing about throughout the entire course.
(Please see article below and PICTO, this will help you understand the topic we will finish for each assignment). You
MUST read and understand the topic that we will be writing about throughout the entire course.

· Each assignment in this course will be used for final assignment, please be serious! Just give you ahead up, the final assignment at the end of course, the main body of the final assignment will include: Problem Statement, Organizational Culture, and Readiness Literature, Review Change, Model or Framework, Implementation Plan, Evaluation Plan)

· APA 7 format, 850-1000-word, double space, Minimum 5 sources and published within the past 5 years.

·
Please ensure that the cited reference is relevant to the content of the paragraph!

·
NO AI or plagiarism because need to submit to school AI and Plagiarism system.

·
Also, when writing the assignment, please consider and related it to my current scope of practice which is
Operating Room Nurse; My future advanced registered nurse role (ARN) will be
Perioperative Nurse Educator (Operating Room Nurse Educator).
Thanks!

Prompt:

To successfully implement a change within an organization, the change agent must assess the organization’s culture and readiness for change.

Include the following:

· Describe the organization’s culture and explain to what degree the culture supports change. Consider
organizational and leadership structure, mission and values, interprofessional collaboration/team engagement, communication, perception of the organization by employees, etc. (You should focus on perioperative/operating room department)

· Select an organizational readiness tool and assess the level or readiness for change within your organization. Identify the readiness tool and summarize the survey results.
(choose readiness tool:
Organizational Readiness for Implementing Change (ORIC))

· Propose strategies to better facilitate the readiness of the organization.

· Discuss the degree to which the organizational culture will support and sustain an evidence-based practice change. Consider strengths and weaknesses, potential barriers, stakeholder support, timing of the proposal, and resources.

· Discuss what health care process and systems you would recommend for improving quality, safety, and cost-effectiveness for the organization.

· Identify the stakeholders and team members for the project. Include what their duties will be in the evidence-based practice project proposal.

· Explain what information and communication technologies are needed for the implementation and how they will be integrated in the setting by the internal stakeholders.

· Explain how these will help improve nursing practice and care delivery for individuals and populations for your intervention.

Thank you!

PICOT Question
P	Population	Adult patients (18-65 years old) scheduled for supine or prone position surgery with a surgical duration of ≥2 hours
I	Intervention	Operating room nurses participated in special training on body positioning care.
C	Comparison	Operating room nurses DID NOT participate in special training on body positioning care.
O	Outcome	Decreased incidence of intraoperative and perioperative pressure injuries and improved patient skin-integrity outcomes.
T	Timeframe	Within 30 days following surgery.
PICOT Create a complete PICOT statement.	In adult surgical patients aged 18–65 undergoing procedures lasting two hours or longer in the supine or prone position (P), does implementing specialized training for operating-room nurses on patient-positioning and intraoperative pressure-injury prevention (I), compared with no specialized training (C), reduce the incidence of intraoperative or perioperative pressure injuries (O) within 30 days post-surgery (T)?
Problem Statement Create a problem statement for your PICOT. You will use this problem statement throughout your final written paper.	The pressure injuries are particularly susceptible to surgical patients because of their immobility, anesthesia, and prolonged pressure on the bony prominences during long surgeries. Recent research has found that intraoperative pressure injuries are caused by prolonged operation period and prone or lateral positions (Mondragon & Zito, 2024). Such wounds delay the healing process, promote surgical infection, and prolong hospital stay, raising the cost of healthcare and patient pain (Choragudi et al., 2024). Advanced Nursing Practice (ANP) encourages evidence-based clinical decision-making, education, and leadership in order to improve performance. The proposed ANP-related intervention is the development and assessment of an operating-room nurse training program oriented on positioning and pressure-injury prevention, which translates existing evidence into practice, reinforces the perioperative nursing competencies, and promotes interdisciplinary collaboration, which will contribute to the safety of surgery. Empirical evidence shows that structured perioperative prevention bundles and staff-education programs reduce pressure-injury and enhance best-practice adherence dramatically (Kandula, 2025). Therefore, the proposed project is consistent with the ANP mission to incorporate research, education, and quality improvement to promote patient-centered care.

Evidence-Based Practice Project: Intraoperative Pressure Injury Prevention Training Program for Operating Room Nurses

Demographics and Health-Related Concerns of the Population

Adult surgical patients aged 18-65 with operations lasting at least two hours in supine, prone, or lateral position constitute a special high-risk group of patients with intraoperative pressure injuries (PIs). This population often has comorbid conditions, such as diabetes, obesity, vascular disease, or limited tissue perfusion, which predispose them to skin breakdown. The inability to move during the anesthesia, the presence of rigid positioning devices, and the lack of movement during the operation increase the risk of localized pressure and shear injuries (Mondragon & Zito, 2024). According to national statistics, up to 27 per cent of surgery patients are at risk of developing early-stage pressure injuries in 24 hours after surgery, which leads to hospitalization and postoperative infections (Usul & Dizer, 2025). The healthcare expenditure on hospital-acquired pressure injuries in the United States is estimated at 26.8 billion a year (Choragudi et al., 2024). The group applies to the nurses operating in the operating room since it concentrates on the significance of high-level knowledge of positioning, collaboration, and compliance with evidence-based prevention measures. These health problems are tackled through education and competency-based training, which enhance perioperative safety, morbidity, and patient outcomes.

Recommended Evidence-Based Intervention and Policy Alignment

The proposed intervention is a special operating-room nurse training program concerning the care and prevention of intraoperative pressure-injury body positioning. The program involves interactive workshops, simulation-based situations, and competency checklists in risk assessment, positioning device choice and placement, micro-repositioning methods, documentation guidelines and interprofessional communication. The training will consider the suggestions of the Association of periOperative Registered Nurses (AORN) Guideline on Pressure Injury Prevention and will be dedicated to the adherence to the standardized risk-assessment scale, such as the Braden scales. Education will be provided by a Perioperative Nurse Educator and will be supported by quarterly audits and feedback to ensure that the behavioral change is long-lasting.

The intervention aligns with the major health policies and goals of the U.S. which promote equity within healthcare and patient safety. One of the healthcare-associated conditions that are considered as a national priority by the Healthy People 2030 program is prevention of pressure injuries to improve care quality and avoid disparities. The competency standardization of OR nurses through the program will ensure that all patients, regardless of their body habitus, comorbidities, and socioeconomic status, receive equal preventive care. In addition, the program reinforces the Centers for Medicare and Medicaid Services (CMS) policy of denying reimbursement to preventable pressure injuries, which encourages hospitals to ensure compliance with prevention. The application of such an intervention as a future Perioperative Nurse Educator represents a high-level nursing practice by providing leadership in the field of quality improvement, staff development, and translation of research to equitable perioperative outcomes.

Comparison with the Past Practice or Research

Historically, preventative measures of pressure-injury in the surgical environment were based on informal staff education and personal clinical decisions without established OR-specific competencies. This led to non-observance of best practices and poor risk assessment documentation. Cebec (2021) found that operating room (OR) nurses have insufficient knowledge reserves for pressure injury prevention, and their clinical practice lacks standardized guidance. OR nurses have not formed a complete closed loop of knowledge, practice, and documentation. Therefore, it is necessary to optimize the preventive measures for pressure injuries. Likewise, Li et al. (2022) discovered that nurses tended to focus on other intraoperative activities instead of skin protection because of workload and institutional insufficient focus on prevention.

Recent translational research demonstrates that complex educational packages and evidence-based positioning guidelines can significantly decrease the occurrence of intraoperative pressure-injury. Kandula (2025) documented an approximate 30% reduction in the occurrence of pressure-injuries after the application of extensive perioperative prevention measures. The proposed intervention is a standardized and data-driven training framework, with performance audits and outcome monitoring, as opposed to the previous methods that lacked an evaluation metric. This practice of research operationalizes research findings, and it supports the role of the Perioperative Nurse Educator to sustain evidence-based competencies within surgical teams. The proposed strategy is more consistent, accountable, and able to produce a quantifiable effect on patient safety indicators than the informal approaches used in the past.

Intervention Anticipated Result

The anticipated key outcome is a major decline in intraoperative and perioperative pressure-injury rates in 30 days after surgery. Secondary outcomes comprise better scores of OR nurse competency in positioning techniques, greater adherence to documentation standards, and better interdisciplinary collaboration. The success will be quantified in relation to the baseline and post-implementation PI rates with the goal of at least a 30 percent reduction in line with the published evidence (Kandula, 2025). It is expected to improve qualitatively in terms of nurse confidence, situational awareness, and proactive communication during positioning. Such results directly promote the objectives of patient safety, decreasing postoperative complications, and the cost of hospitalization of preventable wounds. Moreover, being a Perioperative Nurse Educator, it is possible to show measurable improvements as an institutional support of continuous staff-development programs and in line with organizational quality indicators.

Timeline of Implementation and Evaluation

The implementation will take place within nine months. Months 1-2 will involve curriculum development, administrative authorization, and nurse participant recruitment. Months 3-5 entail the provision of training workshops and simulation, and subsequent post-training competency evaluation. Months 6-9 involve outcome evaluation, pre- and post-intervention audits of pressure-injury incidence, chart reviews, and staff feedback surveys. Descriptive and inferential statistics will be used to analyze data in order to determine the effectiveness of interventions. Continuous knowledge retention and continuous quality improvement will be maintained in the OR team by carrying out ongoing monitoring and quarterly refresher sessions.

Application of Nursing Science, Social Determinants, and Epidemiologic Data

The project is reflective of nursing science in the sense that empirical research is converted into clinical action. The training program operationalizes the evidence-based educational strategies in the perioperative workflows with the help of Li et al. (2022) and Cebec (2021). The design is inspired by nursing theories of patient safety and systems thinking, which connect the human factor, environment, and team communication. Synthesis of scientific evidence into systematic learning modules is an example of how research, practice, and education are integrated by an advanced practice nurse, which is the core of the field.

Socioeconomic and health inequities that contribute to the pressure-injury risk include poor nutrition, obesity, low health literacy, and access to preventive care. The intervention reduces the differences due to the inconsistency of staff knowledge or resource variability by standardizing intraoperative positioning and skin-assessment practices. Training focuses on the fair treatment of patients with body sizes and cultural backgrounds, implicit bias, and standardized protective practices irrespective of demographic variations.

Epidemiologic data has shown a long-term hospital-acquired pressure injury burden on surgical groups. National datasets prove that intraoperative PIs are the cause of postoperative morbidity and higher costs (Choragudi et al., 2024). The incidence and prevalence rates monitored in the pre-implementation and post-implementation period are important epidemiologic measures of success. The application of continuous data surveillance makes the program consistent with the evidence-based public-health strategies of mitigating preventable harm.

Genomic factors contribute minimally to the development of PI, but genetic orientations on skin integrity, collagen formation, and inflammatory response have the potential to contribute to vulnerability. By considering such factors in the preoperative assessment, perioperative nurses can detect high-risk individuals, and preventive measures should be tailor preventive strategies accordingly. With the increased availability of genomic information, genetic-risk education can be incorporated into future curricula by nurse-educators to promote personalized care.

The project can improve population health management by incorporating pressure-injury prevention into perioperative systems, so that the rate of complications, the duration of hospitalization, and economic costs could be reduced. This is in line with quality and safety-oriented value-based care models. Perioperative Nurse Educator position plays a crucial role in maintaining these gains by continuing to assess competency, mentorship, and interprofessional collaboration to enable the overall purpose of enhancing health outcomes at the individual and population levels.

Conclusion

In summary, the operating room nurse training program focuses on positioning care, emphasizing the prevention of intraoperative pressure injuries (PIs), and is based on AORN guidelines and evidence-based practice. This program addresses shortcomings in previous informal education and non-standardized practices. It also enhances the professional competence, record-keeping skills, and teamwork of operating room nurses. This demonstrates the translation of nursing science into practice. Leadership in perioperative nurse education ensures continuous improvement of the program, thereby enhancing individual patient safety and population health.

References

Choragudi, S., Andrade, L. F., Bermudez, N. M., Burke, O., Sa, B. C., & Kirsner, R. S. (2024). Trends in inpatient burden from pressure injuries in the United States: Cross‐sectional study National Inpatient Sample 2009–2019.
Wound Repair and Regeneration.
https://doi.org/10.1111/wrr.13182

Coventry, L., Towell-Barnard, A., Winderbaum, J., Walsh, N., Jenkins, M., & Beeckman, D. (2024). Nurse knowledge, attitudes, and barriers to pressure injuries: A cross-sectional study in an Australian metropolitan teaching hospital.
Journal of Tissue Viability, 33(4).
https://doi.org/10.1016/j.jtv.2024.10.003

Cebeci, F., & Çelik, S. Ş. (2021). Knowledge and practices of operating room nurses in the prevention of pressure injuries.
Journal of Tissue Viability, 31(1), 38–45.
https://doi.org/10.1016/j.jtv.2021.07.007

Kandula, U. R. (2025). Impact of multifaceted interventions on pressure injury prevention: A systematic review.
BMC Nursing, 24(1), 1–20.
https://doi.org/10.1186/s12912-024-02558-9

Li, Z., Marshall, A. P., Lin, F., Ding, Y., & Chaboyer, W. (2022). Registered nurses’ approach to pressure injury prevention: A descriptive qualitative study.
Journal of Advanced Nursing, 78(8), 2575–2585.
https://doi.org/10.1111/jan.15218

Mondragon, N., & Zito, P. M. (2024).
Pressure injury. In
StatPearls. StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK557868/

Usul, O., & Dizer, B. (2025b). Pressure injuries related to the positioning of surgical patients in the operating room and identification of associated risk factors: A cross‐sectional study.
International Wound Journal, 22(7).
https://doi.org/10.1111/iwj.70685

McAuliffe, P. B., Winter, E. E., Talwar, A. A., Desai, A. A., Broach, R. B., & Fischer, J. P. (2023). Pressure ulcer trends in the United States: A cross-sectional assessment from 2008–2019.
The American Surgeon, 89(12), 5609–5618.
https://doi.org/10.1177/00031348231158691