Bed Sores Case Study

Quality improvement issues in healthcare focus on the care that patients receive and the outcomes that patients experience. Nurses play a major advocacy role for ensuring safe and quality care to all patients. Also, nurses share the responsibility in leading the efforts in improving patient care in all settings (Berwick, 2002). One of the ongoing problems plaguing hospitals and nursing homes is the development of new pressure ulcers in patients after admission. A pressure ulcer can be defined as a localized area of necrotic tissue that is likely to occur after soft tissue is compressed between a bony prominence and a surface for prolonged periods of time (Andrychuk, 1998). According to the Centers for Medicare and Medicaid,

Special dressings and bandages can be used to protect and to speed up the healing of pressure sores.

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

Pressure ulcers continue to be a prevalent issue in the health care system and causes “pain, slow recovery from morbid conditions, infection and death” (Kwong, Pang, Aboo, & Law, 2009, p. 2609). In the field of nursing turning and repositioning patients is a well-known nursing intervention to prevent development of pressure ulcers. However, many hospitals and facilities still neglect to apply this as a standard policy. This gives room for nurses and nursing aides to overlook the importance of this intervention resulting in increased pressure ulcer development. The purpose of turning and repositioning patients is to prevent oxygen

Most mobile patients are able to reposition themselves, while others who are critically ill are not able to feel or respond to pain. Therefore, nurses need to assess those patients in repositioning to decrease the risk of developing pressure ulcers (REF).

Braden scale (Braden & Makelburts, 2005) use in hospitals allows nurses to identify patients at risk for pressure ulcer based on their sensory perception, mobility, activity, moisture and nutrition. Although the Braden scale is a useful tool but healthcare administrations has yet found the best method to eliminate pressure ulcers or bedsore in intensive care units. The use of foam dressing will be introduced to the intensive

Due to the patient being bedridden and immobile they often lie in the same position for long periods of time without being moved and the pressure on the skin can cause a sore and infection. If left untreated can cause serious problems and may result in surgery.

It is important to avoid or prevent the vulnerable areas or where sores has already formed. Regularly changing position or moving helps to prevent pressure sores developing in a vulnerable areas or to relieve already existing ones.

J to prevent hospital acquired pressure ulcers. Frequent turning, repositioning, meticulous skin care and assessment are appropriate steps that would be taken to prevent pressure ulcers.

"Hospital-acquired pressure ulcers were shown to be an important risk factor associated with mortality," per Dr. Courtney Lyder, of the UCLA School of Nursing. "It is incumbent upon hospitals to identify individuals at high risk for these ulcers and implement preventive interventions immediately upon admission." Pressure ulcers, also known as bedsores often occurs when patients have limited mobility and unable to reposition themselves in bed causing injury caused by pressure, friction and

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

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

If patient is healthy enough to walk around the place, his linen need not be washed regularly (after he leaves) and he does not need bed

In my workplace, we have recently implemented that if a patient is admitted from the ER or directly admitted from a physician’s office and they have any sensory impairment we must order them a “Stryker” overlay mattress. The stryker softcare overlay mattress is a single patient use mattress put in place in hope of preventing pressure ulcers. The mattress works by redistributing pressure to other areas by removing the constant pressure on pressure points along boney surfaces. This assist

Patients get a pressure ulcer for a legion of rationalities. According to Alene Burke of Nursing Assistant Education, some of the elements why people get them which she cited from Nettina, S. (2009), are old age, deficient mobility, lack of moisture, and insufficient diet. Moreover, factors like neurological and other physical problems, friction and shearing, bed and chairs with wrinkled linens or hard objects and pressure ulcers in the past may similarly predispose pressure ulcer. This observations implies that in nursing care pressure ulcers are prospected as negligence, however it is arrogated that pressure ulcers are avoidable on the condition that prime level of care is continuously rendered to patients and residents. (Burke 2010).