Best Evidence Based Practice Of Prevention And Management Of Pressure Ulcers

Evidence-based practice is extremely important in health care. It is not only important to know how to perform a certain skill, but why it should be done. There needs to be a standard of care and providers need to know the best way of doing things based on evidence. The article mentions that in the 20th century, many medial decisions were made on doctor assessment and preference (Brower, 2017). Many physicians were practicing dramatically different when compared with one another, which led to the realization that changes needed to be made and Evidence-based practice began to develop. Even though Evidence-based practices have been in play for a while, there is a gap between understanding and applying evidence-based

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.

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).

Evidence-based practice is an approach used by health care professionals to continually use current best evidence-based research to make ethical and reliable decisions regarding patient care. “Research to promote evidence-based practice is becoming more and more a part of the regular work of health care leaders” (Grand Canyon University, 2015, p. 1). However, it is important to determine the difference between solid research and flawed research that provides unreliable inferences. Evidence-based research includes focusing on a clinical question; and includes the review and incorporation of several studies to strengthen the results of the new study (Grand Canyon University, 2015). Roddy et al. and Ganz et al. articles will be assessed to determine if the recommended changes were backed by solid research that warrants changes in a hospital.

Pressure ulcers that occur in the long term care setting are increasing in the number of incidences each year in the United States. Consequences and complications of pressure ulcer development include pain, sepsis, cellulitis, bone, and joint infections. Pressure ulcers are also associated with an increased morbidity and mortality rate, negative emotional and physical effects on patients and caregivers, and are the second leading cause of litigation in long term care facilities. The cost of treatment for pressure ulcers in the United States is estimated at 11 billion dollars annually. This has led to many programs that focus on education and intervention to prevent the development of pressure ulcers, even being addressed in public initiatives such as Healthy People 2010. Appropriate information and education for healthcare providers, patients, and families has proven to be a key factor in the prevention of pressure ulcer development. Wound management is an area of healthcare that must include a comprehensive plan for the best outcome. A care plan that includes a well-educated care team composed of various disciplines working together for holistic care of each patient has seen the best results for patients who suffer from pressure ulcers.

Implementing prevention plan for pressure ulcers would become a marker for a quality of care, which ultimately leads to improvement of quality by making healthcare more reliable, accessible, patient-centered and safe. As a part of the pressure ulcer prevention plan effort, one should regularly assess the pressure ulcer rates and practices. Steps to regularly monitor are: An outcome which can be pressure ulcer prevalence or incidence rates. Minimum one to two care processes (ex: skin assessment). Key aspects of the organizational structure to support best care practices. Below are the steps that will help to develop processes and measures for assessing pressure ulcer and practices.

Informative resources generated by project team needs to be disseminated to create awareness. Clinical benefits and outcomes needs to be discussed by the project team with medical staff. The feedback from the staff will fetch constructive outcomes to the project. “The prevention of pressure ulcer should become a standard part of yearly staff education fairs or other similar events (Berlowit et al. 2014)”. The unit without formation of pressure ulcers within 6 hours of admission should recognized and awarded for their hard work. Surveys must be provided to patients to assess their knowledge regarding prevention of pressure ulcers. That way patients and their families can be involved in the

Pressure ulcers are a commonly seen problem among elderly hospitalized patients. Despite new findings about the causes and approaches to treatment, the incidence of these wounds is still increasing. Scott, Gibran, Engrav, Mack and Rivara (2006) revealed that during the thirteen years of their study, the incidence of pressure ulcer development has more than doubled. As our elderly population becomes greater in number, and older in age, this problem is expected to escalate. It is of great importance for the patients as well as for the

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

Pressure Ulcer is a breakdown of skin appears on the skin over a very thin or bony prominence

Pressure ulcer prevention requires a team effort, involving physicians, nurses (including wound, ostomy, and continence nurses), dietitians, and physical therapists. Studies have demonstrated that comprehensive pressure ulcer prevention programs can decrease incidence rates, although not to zero. For optimal effectiveness, pressure ulcer prevention must begin as soon as patients enter the

Pressure ulcer is an adverse outcome in the clinical care setting that also linked to poor quality of nursing care. Though pressure should never happen in a professional care setting, it is still prevalent throughout the world’s medical settings. This article looks at many other previous studies from 1992 to present to compare and find the underlying issues that may contribute to pressure ulcer. A closer look at the nurse’s knowledge versus actual decision will be observe, because it is the key factor in pressure ulcer prevention.

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