Chronic Pressure Ulcers

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).

An interdisciplinary team of professional staff is a necessity to overcome the issue of pressure ulcer development among patients. Relevant stakeholders would include a nurse, nurse aide, dietitian, and a hospitalist. The primary responsibilities of the nurse consist of completing and documenting skin and risk assessments, monitor progress and/or changes in medical/skin conditions, report patient problems to the hospitalist, and work with the wound team

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

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.

During my short time in nursing school, and even shorter time I have been in clinical I have found that pressure ulcers seem to interest me the most. I think this is due to the fact that some nurses have told me that pressure ulcers are completely preventable if you turn your patient frequently, and some have told me that they are not preventable that some patients are just more prone to getting pressure ulcers. When choosing a PICOT question I chose a question about pressure ulcers because it seemed to fit my interests the most. I have developed the question of: In patients over the age of 18, how does the use frequent turning compared to not receiving the frequent turning influence their risk of developing pressure ulcers during their

It is important to count & track pressure ulcer rates as a major factor for quality improvement. Being able to track pressure ulcer rates, care can be altered to better improve medication interventions and ultimately decrease the rates of pressure ulcers. It also allows the interdisciplinary team members be able to gain perspective on data trends. Improvement efforts are ongoing basis and the AHRQ recommends that pressure ulcer incidence or prevalence rates be monitored to determine outcomes, utilization of at least one or two skin assessments, and determine responsibility for overseeing accuracy of skin assessments.

Pressure ulcers remain a major health problem for many years. However, pressure ulcers have received minimal attention when we talk about patient safety issues. It is no doubt a patient safety issue as it can lead to serious damage such as life-threatening infections (Robyn). On a med/surge unit, individuals may experience long or short hospital stays depending on the situation. For the short stays, the focus of care is often on maximizing regaining activities of daily living and assessment and education regarding pressure ulcers is often minimal or non-existent (RNAO). What we fail to realize is that every patient who is at risk needs to be assessed and educated regarding pressure ulcers and the harm it can cause. During the hospital stay, patients may have limited movement and the pressure ulcers can extend into the muscle, tendon, and bone (RNAO). In many cases, patients do not notice the formation of an ulcer and as it may be in areas that are not as visible such as the coccyx. On a unit where there is short staffing, it is more vital to remember to assess for pressure ulcers and prevent the formation of an ulcer. Often, patients are admitted with the presence of a stage one or two pressure ulcer, whether it was from home or long-term care. In that case, patient education need to take place and teachings should be reinforced regarding the prevention of new pressure ulcers forming. Clients should also receive education regarding how to prevent

Pressure ulcers are a serious problem in the medical world today. They affect millions of people and cost medical facilities billions of dollars annually. In order to help prevent pressure ulcers, it is important to understand how and why they happen, the risk factors involved for patients and what can be done to prevent them. Many studies have been done to assess different techniques for preventing and treating pressure ulcers. In addition to using the best medical products, it has been found that proper education for the nurse and the patient plays an integral role in the prevention and treatment of ulcers. This paper will discuss evidence based practice, the nursing role, and client education in pressure ulcer formation and healing.

problem. It not only cause pain, slow recovery from the sick skin condition and prolonged hospital stay but also increase health care costs and nursing time. It occurs in patients of all age group. According to the statistics, it cost $9.1-$11.6 billion and 2.5 million people affect Nation wild each year ( Are We Ready for This Change? | Agency for Healthcare ... n.d.). The skin lesions cause patient suffering from pain, and the risk for infection. In this essay, the student will present a pressure ulcer prevention program (PUPP). Discussing the purpose of the program, the target population, and the benefits of the program associated with the cost. At the final, the student will evaluate the possibility to implement the program.

The National Pressure Ulcer Advisory Panel defines pressure ulcer as “localized injury to skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear.” Pressure ulcers are caused by unrelieved pressure usually located over bony prominences and are localized area of tissue injury. Agency of Healthcare Research & Quality has an effective vision regarding pressure ulcers: If you can’t measure it, you can’t improve it. To determine the severity of a pressure ulcer, an assessment of the lack of skin integrity is categorized according to severity by stages to reflect level of tissue injury or damage . Variations in the breakdown of skin are staged to correspond to the level of wound severity and the extent of tissue involvement which can range from mild reddening of skin to severe tissue damage to muscle and bones. Pressure ulcers can also result in severe infection.

The expression ‘complex care’ denotes the impact multifarious diagnoses and their subsequent implications have on an individual, and therefore the varying facets of care management required. This may be due to physical, developmental, behavioural or emotional conditions requiring various long-term interventions to ensure survival and positive quality of life (McPherson et al. 1998). A more recent paediatric specific definition, taking into consideration the advances in healthcare leading to both increased survival rates and progress in medical technology, suggests that children with complex care needs may rely on long term assisted

One of the greatest indicators for the quality of care is health care facilities is the amount of pressure ulcers acquired in patients. Approximately 1 million people develop hospital-acquired pressure ulcers each year affecting hospitalized patients in both acute and long term care settings. The incidence of pressure ulcers ranges from 0.4%-12% in acute care settings, along with the prevalence range from 12%-18%. Pressure ulcers cause increase pain, suffering, and decreased quality of life along with extended hospital stay. According to the national pressure ulcer advisory panel a pressure ulcer is defined as “localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination

Pressure ulcers additionally called bedsores or pressure sores, are wounds to skin and fundamental tissue coming about because of delayed weight on the skin. A pressure ulcer is confined damage to the skin or basic tissue more often than not over a hard unmistakable quality, as a consequence of weight, or weight in blend with shear and contact. Since muscle and subcutaneous tissue are more defenseless to weight incited harm than skin, bedsores are regularly more awful than their introductory appearance. Pressure ulcers are then organized to direct clinical depiction of the profundity of detectable tissue demolition. It is assessed that these ulcers commonness in intense consideration is 15%, while frequency in intense consideration is 7%. It is evaluated that 2.5 million patients are treated for bedsores in US wellbeing acute care facilities every year. Pressure ulcers cause significant damage to patients, obstructing useful recuperation, often bringing on torment and the improvement of genuine diseases. They have additionally been connected with a broadened length of stay, sepsis, and mortality. Truth be told, about 60,000 US facility patients are assessed to pass away every year from complexities because of these ulcers. The evaluated expense of dealing with a solitary full thickness ulcer is as high as $70, 000, and the aggregate expense for treatment of pressure ulcers in the US is assessed at $11 billion every year.

After reviewing the dialogue between the nurses and the surgeons, it was necessary to delve into the quality management method that were utilized in the hospital. Anytime a patient develops pressure ulcers, it is a sign of negligence in most cases. The surgeons are knowledgeable in knowing that the skin will breakdown with prolonged decreased bed mobility. Consequently, having a meeting to discuss changes in the quality assurance management methods is an indicator that there were some deficits in the delivery of healthcare. The fact that the Never Event occurred shows there was a breakdown in the quality assurance process in the hospital.

According to the textbook, nurses in various settings are adopting a research-based (or evidence-based) practice that incorporates research findings into their decisions and interaction with clients. How do you see this being applied in your workplace?