Analysis Of The Shear And Frictional Properties Of 5 Sacral Dressings

According to, the European Pressure Ulcer Advisory Panel (EPUAP), National Pressure Ulcer Advisory Panel (NPUAP) and Pan Pacific Pressure Injury Alliance (PPPIA) classification system (2014) pressure ulcers are categorised into four stages depending on their severity. Stage one: skin still intact with non-blanching, redness with swelling present. Stage two: the skin breaks open or forms a blister without slough and is usually tender or painful. Stage three: pressure sore becomes worse, slough may be present and extends into the tissue beneath the skin where subcutaneous fat may be visible but bone, tendon or muscles are not exposed. Stage four: pressure sore becomes very deep reaching into the muscle or tendon causing extensive damage with necrosis. However, pressure ulcer staging is dependent on visible skin characteristics therefore misclassifying pressure-related injury can remain undetected for days or weeks before a purple discolouration of the skin appears (Mallah, Nassar and Badr, 2014).

1.1 describe the anatomy and physiology of the skin in relation to skin breakdown and the development of pressure sores.

1. describe the anatomy and physiology of the skin in relation to skin breakdown and the development of pressure sores

Outcome 1: Understand the anatomy and physiology of the skin in relation to pressure area care

Pressure ulcers are one of the most common problems health care facilities often face which causes pain and discomfort for the patient, cost effective to manage and impacts negatively on the hospital (Pieper, Langemo, & Cuddigan, 2009; Padula et al., 2011). The development of pressure ulcers occur when there is injury to the skin or tissue usually over bony prominences such as the coccyx, sacrum or heels from the increase of pressure and shear. This injury will compromise blood flow and result in ischemia due to lack of oxygen being delivered (Gyawali et al., 2011). Patients such as those who are critically ill or bed bounded are at high risk of developing pressure ulcers (O'Brien et

Thus, the expected outcome is that there is prevention of skin breakdown relating to pressure ulcers during hospitalizations for patients.

To start the search for evidence within University Hospital, questions were asked in regards to pressure ulcers. Monthly updates are often sent out via email from the wound care team to keep everyone up to date on knowledge. While there was informative numbers within those updates, this information falls short according to Moore, Webster, & Samuriwo (2015). The main limitation of the study is the lack of a control group in pressure ulcer prevention and treatment. There is no clarity in the specific criterion that contributed to improved clinical outcomes. Teams used more than one method in the research project. Also, there is no study that meant the inclusion criteria in the random clinical trials. The lack of standardized

While nurses encounter patients with pressure ulcers in home care and acute care settings, they are mainly a problem with elderly adults in long term care facilities. This is because of decreased sensory perception, decreased activity and mobility, skin moisture from incontinence, poor nutritional intake, and friction and shear (Stotts and Gunningberg, 2007).

Pressure ulcers are areas of localised damage to the skin and underlying tissue caused by pressure. (Stechmiller et al., 2008) Pressure ulcers still one of the most significant health problem in our hospitals today, It affects on patients quality of life patient self-image and how long they will stay in hospital then the cost of patient treatment . Moore (2005) estimate that it costs a quarter of a million euro’s per annum to manage pressure ulcers in hospital and community settings across Ireland .which allows one to take immediate actions and prevent the ulcer if possible. To support pressure ulcer risk assessment several standardized pressure ulcer risk assessment scales have been introduced

Despite advancement of technology, pressure ulcer continues to be a primordial in the health care system. Prevention of pressure ulcer remains an important issue in the health care facility. The critically ill ICU patient is the main target of this disease. Prevention remains the key for this problem. Some facility have standard policy for the eradication of pressure ulcer However the question is will the sacrum pressure ulcer formation be reduced in adult critically ill clients

Pressure ulcers occur over bony prominences when skin is compressed for long periods of time, affecting the blood supply to certain areas, leading to ischaemia development (Waugh and Grant, 2001). Compression of skin is caused by pressure, shearing and friction, but can also occur due to pressure exerted by medical equipment (Randle, Coffey and Bradbury, 2009). NICE (2014) states that the prevalence of pressure ulcers in different healthcare settings in December 2013 was 4.7%, taken from data available for 186,000 patients. The cost of treating ulcers can vary depending on severity from £43 up to £374 (NICE, 2014). Evidence based practice skills are essential in nursing as it allows the best available evidence to be used to improve practice and patient care, while improving decision-making (Holland and Rees, 2010). I will be critiquing two research papers; qualitative and quantitative, using a framework set out by Holland and Rees (2010), and will explore the impact on practice. Using a framework provides a standardised method of assessing quality and reduces subjectivity.

In addition to identification and prevention, there are products that can be used in order to prevent occurrence of HAPUs. The purpose of this project is to implement use of foam dressing called Mepilex Border proven to help prevent pressure ulcers when used in addition to the prevention protocols by redistributing pressure, reducing friction, and providing an optimal microclimate. It combines antimicrobial action of ionic silver with soft silicone adhesive providing healing and reduced pain (Barrett, 2009). Mepilex dressing can be repositioned after skin assessment making it easy to assess the wounds without need for reapplying new dressing after each assessment.

20). Further, the presence of pressure ulcers places a burden on patients and their family (Grinspun, 2005, p.21). As recommended by Grinspun (2005), pillows and foam wedges to separate prominences of the body and lifting devices have been beneficial to avoid friction (p. 32). Research suggests that the majority of pressure ulcers can be avoided. Although, the population at risk likely suffers from the possible contributors, as stated repositioning at least every 2 hours or sooner was effective (Grinspun, 2005, p. 32). When practicing I will reposition patients at appropriate times to reduce the risk of damage to the skin. Additionally, when moving a patient up in bed, I will request adequate assistance from other nursing staff to use a lifting device. This will help to avoid friction while the patient is being moved, ultimately reducing the development of pressure

The article that I chose to expound on is, in its fullness, called, ‘Reducing Pressure Injuries in Critically Ill Patients by Using a Patient Skin Integrity Care Bundle (InSPiRE)”. The purpose of this research article was to test if critically ill patients using their InSPiRE protocol fared better than those who receive traditional treatment options. By implement this process they were able to minimize the development of new occurrences of pressure injury in patients who are in the hospital for longer periods of time.. According to the article, a pressure injury is, “localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or

Pressure Injuries—often referred to as pressure sores, bed sores, pressure ulcers or decubitus ulcers—are the injuries, sores, inflammation or ulcers in the skin over a bony prominence due to constant pressure or friction. The common sites for pressure injuries are sacrum, heels, elbows, ankles, hip, knees, occipital bones and shoulder blades (Harris, Nagy &Vardaxis, 2010, p.1404). A shearing force or a frequent pressure on a bony prominence tends to block the blood supply which leads to ischemia or cell death. Elderly, incontinent, wheelchair or bed-bound individuals are prone to pressure sores. However, it also depends on the individual’s skin integrity and weight (Brown & Edwards, 2012, p. 239). The pressure injury can affect any person of any age. Therefore, every patient requires an assessment for risks regardless of gender, age or weight. A pressure injury can develop with both the high pressure for short duration and low