A pressure injury is when an amount of pressure is applied to the skin over a bony prominence causing the skin or tissue to breakdown resulting in an injury. In Cathy Hess’s article “Arterial Ulcer Checklist” she stated “Arterial insufficiency refers to impairment of arterial blood flow leading to tissue ischemia and potentially necrosis” (Hess, 2010). They are classified into stages, with stage one being the low-grade injury with erythema and temperature to the unstageable or deep tissue injury that is ulcerated with skin breakdown. I decided to write about arterial insufficiency ulcers. The cause of these injuries varies but one of the common reasons is due to vascularity problems such as diabetes, high blood pressure, smoking, arteriosclerosis …show more content…
In an arterial injury, it will look as if the injury is “punched out” with round and smooth edges. These injuries are very painful. The injury will usually appear creating a hairless area and may be cooler than other areas of the body. Some common areas for these injuries to appear are the leg, foot, heels and toes. Arterial injuries can be classified as a full thickness wound which adipose tissue is visible and granulation tissue is present. Full thickness injuries usually expose the underlying structures and can be either deep or shallow depending on the severity. There may be visible necrotic tissue in the wound bed if the injury happens to be under treated or other contributing …show more content…
The area of the injury must be observed for how well the circulation to this area is. While preparing for treatment, nurses can use a chart called the “Braden Scale” which determines different factors that contributed to the injury, which will give them a better idea about which treatment plan they should follow. In DeWitt’s “Medical-Surgical Concepts and Practices” it describes the scale having 6 factors that can contribute to a pressure injury as in “sensory perception, moisture, activity, mobility, nutrition, and friction and shear” (DeWitt, 2013). It is easier to prevent pressure injuries than it is to treat them, that is why constant interventions are created to decrease the incidences of pressure injuries. A patient with an arterial pressure injury, depending on the severity will have a reduction in pressure over the area. Once the damage is done, the next measure is to relieve the pain and begin to start treatments. One simple way to help alleviate the pain is to dangle the affected area. This causes the blood to pull towards the feet increasing the blood flow to the lower extremities. One of the more tolerable treatments for an arterial pressure injury is to loosely wrap the affected area after receiving the cleaning. Other simple suggestions are to stop smoking, maintenance of high blood pressure, proper care if diabetic and change in diet.
The research article "What influences the impact of pressure ulcers on health-related quality of life? A qualitative patient-focused exploration of contributory factors" was recently published (2012) in the Journal of Tissue Viability by Gorecki, Nixon, Madill, Firth, and Brown. This is a qualitative study.
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
Agrawal, K., & Chauhan, N. (2012). Pressure ulcers: Back to the basics. Indian Journal Of Plastic Surgery, 45(2), 244-254.
Pressure ulcer prevention (PUP) in surgical patients has become a major interest in acute care hospitals with the increased focus on patient safety and quality of care. A pressure ulcer is any area of skin or underlying tissue that has been damaged by unrelieved pressure or pressure in combination with friction and shear. Pressure ulcers are caused due to diminished blood supply which in turn leads to decreased oxygen and nutrient delivery to the affected tissues (Tschannen, Bates, Talsma, &Guo, 2012). Pressure ulcers can cause extreme discomfort and often lead to serious, life threatening infections, which substantially increase the
In order to facilitate understanding of process data and outcome data, this essay will focus on the context of hospital-acquired pressure injury (PI). PI, also referred to as decubitus ulcers, bed sores or pressure sores, is defined as soft-tissue ischaemic necrosis localised in an area caused by prolonged pressure higher than the capillary pressure with or without skin tear or breach, related to posture over a bony prominence. The aetiology of pressure ulcers include: (1) pressure – weight of the skin against contact area; (2) shearing; (3) friction; (4) moisture; (5) position of the patient; (6)immobility; (7) neurological factors; (7) metabolic and nutritional factors; (9) oedema; and (10) age. PIs affects not only in infirmed older people,
This step is very useful to help limit swelling to the injured area and keeps it from progressing to other parts of the limb. Be careful not to put direct pressure on an eye injury, and watch carefully for coolness or in case of change the color of the skin under the bandage. If any of these symptoms occur, remove the bandage quickly and re-wrap it less tightly. After that raise the injured organ to a level higher than the heart. For example, raise the affected arm or leg by using cushions or pillows to help decrease blood pressure and slow the
A pressure ulcer is a localized injury to the skin usually over bony prominence, as a result of pressure, or pressure in combination with shear. It is estimated that 5 to 10 percent of patient admitted to the hospital acquire a pressure ulcer and it result in increased suffering, morbidity and mortality. The policy titled Pressure Ulcer Prevention and Managing Skin integrity provides direction for the nurses to prevent the development of pressure ulcer. It
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).
Pressure Ulcers affects patients the older patients due to the problem of immobility. A pressure
Pressure ulcers have a direct effect on patients and health care organizations. These effects will be discussed below, first looking
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
Pressure ulcers are a problem and can lead to poor patient outcomes as well as hospital fines. Evidence based studies have shown that “the average cost of care in an acute care hospital for a patient with a stage III or stage IV pressure ulcer reported by the Centers for Medicare & Medicaid Services (CMS) is $43,180” (Jackson, 2008). Pressure ulcers and other skin breakdowns are among the most significant adverse events causing distress for patients and their care givers and compromising patients’ recovery from illness or injury (Gardiner, 2008). It is the tasks of nurses to ensure prevention of these complications is part of the daily care regimen.
Outcome 1: Understand the anatomy and physiology of the skin in relation to pressure area care
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
A common health concern seen in the elderly, especially those within institutions, are pressure ulcers. A pressure ulcer is defined as a localized injury to the skin or underlying tissue that occurs when something keeps rubbing or pressing against the skin. Pressure on the skin causes a decrease of blood flow to that area and as a result, an ulcer may form because of the skin dying due to the lack of blood in that region. They generally occur over bony prominences such as, the buttock, elbow, hip, heel, back of the head and ankles. An ulcer has a greater chance of forming if the person uses a wheelchair or stays in bed for a long period of