Essay on Case Study on Pneumonia

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.

What influences the impact of pressure ulcers on health-related quality of life? A qualitative patient-focused exploration of contributory factors (Gorecki, Nixon, Madill, Firth and Brown, 2012)

| This is important because we need to look at the relevant data and realize that she seems to be in distress and first take care of that. Also realize that she seems to have an infection. With this information we are able to prioritize

A.W., a 52-year-old woman disabled from severe emphysema, was walking at a mall when she suddenly grabbed her right side and gasped, “Oh, something just popped.” A.W. whispered to her walking companion, “I can’t get any air.” Her companion yelled for someone to call 911 and helped her to the nearest bench. By the time the rescue unit arrived, A.W. was stuporous and in severe respiratory distress. She was intubated, an IV of lactated Ringer’s (LR) to KVO (keep vein open) was started, and she was transported to the nearest emergency department (ED).

Air escaped from the lung into the pleural space. Eventually, enough air collected in the pleural space to cause the mediastinum to shift twoard the right. The collapsed left lung, increased intrapleural pressure, and rightward shift make it difficult to ventilate A.W.

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

Position for the patient that will lead to the worst ventilation-perfusion matching is lying supine with no pillows. This position will causes significant reduction in lung volumes and flow rates which increases work required for breathing. Without a pillow to prop the patients head up leads to further restriction of the airway and an increased the risk for hyperventilation. Standing up straight is also detrimental because of gravity acting on the overproduction of mucous, causing it to drain into parts of the lungs making it even more difficult to expel. The best position for R.S. when sleeping is sitting up straight at a at least a ninety degree angle. But even that is a hassle as it's not always comfortable. He may prefer to sleep on his

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 during a hospital admission are preventable. Assessment and early intervention can stop skin breakdown before it begins. Many factors regarding Mr. J’s condition placed him at a high risk regarding nursing indicators. Mild dementia, recent fall and a fractured hip all require a high level of nursing care and indicates preventative practice. Upon assessment, precautions should be in place to deter further complications. The elderly are more

A study conducted over seven years by Amir et al (2011) showed a significant decline of pressure ulcer development after three years of the study. This was partly due to strategies being implemented in regards to repositioning along with adequate nutrition, pressure ulcer prevention information leaflets were given to patients and skin assessments (Amir et al., 2011). It must also be considered that different patients will have different comorbidities and the use of a risk assessment tool is vital to assess and implementing a plan for pressure ulcer prevention according to the patient’s score (Tannen et al., 2010).

Evidence suggests that pressure ulcers greatly increase mortality rates in both hospitals and nursing homes (Thomas, 2001). Patients who develop a pressure ulcer within six weeks of admission to an acute-care facility are three times more likely to die than patients who do not develop pressure ulcers (Thomas, 2001). Moreover, patients who develop a pressure ulcer within three months of admission to a long-term care facility are associated with a 92% mortality rate compared with a 4% mortality rate for patients who do not develop them (Thomas, 2001). This evidence alone shows how significant this problem is to the overall health status of patients. In my personal nursing experience, I have heard many complaints voiced from patients and their family members concerning the development of new pressure ulcers. Patients and family members have expressed dissatisfaction because of the increased stress and prolonged hospital stay often associated with the treatment of pressure ulcers.

Braden scale is a tool used to predict patient’s risk for pressure ulcer. However, when this tool is not used to its fullest potential, it does not help to decrease the patient’s risk of developing pressure ulcers. Many over look a Braden score of sixteen is being high and not at risk but, scores under eighteen are considered to at risk for pressure ulcer development. Nursing interventions need to be in place before a new development of pressure ulcers. Nurses need to use these provided tools and carry out appropriate nursing interventions according to the results. When a nursing care is not a written requirement, many nurses overlook the benefits of the tool and neglect to provide the best nursing care.

The INTACT trial showed a significant reduction in pressure ulcers (PU) incidence in the intervention group at the hospital (cluster) level, but this difference was not significant at the

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.

In conclusion, managing and preventing the rise of PU incidence in an enormous aging population has remained a challenge in both hospitals and community. With many people being affected each year from the incidence of PU, a change in prevention and management is desperately needed. Healthcare professionals, nurses and patients have several options to help manage and reduce the risk of developing a PU: manually repositioning patients or the use of support surfaces (alternating pressure air mattresses). Most of the articles gave supportive evidence in their argument for using the alternating pressure air mattresses to managing and reducing the risk of developing PU. Each measure had its merits. Nurses are continuously learning and disseminating