Clock Drawing Test For Dementia

“Pressure ulcers are key clinical indicators of the standard and effectiveness of care (Elliott, Fox & McKinley, 2008).” L.M. was at high risk for pressure ulcers for multiple factors such as immobility, poor nutrition, age, and health. Therefore, I used the Braden Scale as a quality indicator in order to assess the risk of pressure ulcers and also to

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

Nonverbal behaviors are extremely variable, especially for chronic pain syndromes. Will aid in detection and assessment.

The specific groups I will be comparing will be patients over the age of 18 during their hospital stay. I will be looking at how the use frequent turning my help prevent pressure ulcers compared to not receiving the frequent turning. After the pressure ulcer is developed I will examine the different treatments available for healing. I am interested in the specific outcome of having no significant pressure ulcers on any patient. This is to ensure patient safety and their well-being. As stated before pressure ulcers can cause big problems including death. If a pressure ulcer has developed some outcomes for that would be wound size reduction, loss of pain and sensitivity to that area, preventing sepsis, and eventual

Pressure Ulcers are a common issue for hospitals and long-term nursing facilities nationwide. Annually an estimated cost of $143 million is spent on hospital acquired conditions which include pressure ulcers (Kandilov, Coomer, & Dalton, 2014). Hospital acquired pressures ulcers are among the top five conditions (Kandilov, Coomer, & Dalton, 2014). Ultimately the first line of defense is prevention and therefore this paper will focus on a clinical practice guideline for deterring the pressure points that progress tissue breakdown and patient harm.

From 11 years and differentiate between them and others and use words that refer suffering, whether physical or psychological type. Moreover, it is important to translate the scales in ratings that suit the analgesic ladder for pain control. Although the scales have different scores, they tend to go from 0 to 10 and may be staggered as follows: 0: no pain, 1-3: it would be a mild

We then assessed the patient on the 7 subscales of the Braden Q. These include mobility, activity, sensory perception, moisture, friction/shear, nutrition, tissue perfusion and oxygenation. Each of these sections is scored from 1-4 with the highest score being 28 (very little risk of pressure ulcer development) and the lowest is 7 (high risk of pressure ulcer development) (See appendix for full scale for Patient P). Based on our assessment date we scored Patient P as bedfast, has no sensory perception below his neck, wears a brief, is G-tube fed and he experiences bouts of decreased oxygen saturation < 95%. His cumulative score for the Braden Q was a 13 and categorizes him at high risk for developing a pressure ulcer (PU). In particular, the scale highlighted lack of mobility, bedfast-ness and friction and shearing as being risk factors in PU development in Patient P. Based on this information I targeted my interventions to address these

Validity: Overall the study is valid but limited as the study examined individual patients as a single case making the ability to generalize limited. The foremost dilemma with the study is the challenge in determining the difference in scores that correspond directly to a clinically important modification. The ability of the VAS to detect significant changes relies heavily on an established baseline as a standard to compare future data. Throughout the duration of the study, patients were asked frequently to complete the VAS and RMQ, this may possibly lead to learning effects which may impact the results of the pain and functional status

A pressure ulcer is defined as hospital-acquired when the patient ulcer has been observed 24 hours after admission. Interventions to prevent HAPU are to turn/reposition patient every two hours for pressure reduction, use of a soft silicone foam dressing for suspected deep tissue pressure ulcer, keep skin dry by applying a skin barrier cream and to monitor incontinence to keep skin moisture free, assess skin daily by using the Braden scale and document findings, and encourage a high protein, fluid, and micronutrient diet for the patient to prevent pressure ulcers. The rationale for implementing these interventions are to prevent pressure relief and formation of a

Nurses are accountable for delivering safe pressure ulcer prevention for patients who are at risk. Pressure ulcers can cause considerable amount of pain and distress in patients with nutritional deficiencies and can also cause high healthcare expenses due to extended hospital stay. Marlene Varga defines a pressure ulcer as “a localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear” (Varga, 2015, p. 26). Significant to nursing practice, evidence-based pressure ulcer protocols are incorporated through research and clinical capability with the intention of aiding practitioners to make evaluations in accordance with current practices and studies (Chaves, Grypdonck, & Defloor, 2010). In hospitalized patients with nutritional imbalances, how would repositioning and turning the patient compared to the use of redistribution or patient positioning system devices manage existing pressure ulcers and prevent new ones from forming?

Since the first classification system for Pressure ulcer, developed by Shea (1975), other systems had been developed to describe the different degrees of tissue damage, with varying numbers for stages ranging from a 0- to 5-stage classification to a 1- to 7-grade classification (Witkowski & Parish 1981, Dealey & Lindholm 2006).

(IHI, 2011). The implementation of preventative interventions and assessment of patients at risk for pressure ulcers can decrease in occurrence of pressure ulcers. Implementation of protecting bony prominences, repositioning frequently, redistributing pressure surfaces, bladder and bowel management, and skin assessment are some interventions. Therefore, IDT education and effective communication are essential for the process to be successful. The team will use a check list on purposeful hourly rounding with the intention to keep patient safe, comfortable. The IDT will implement the Plan-Do-Study-Act (PDSA) model as a guide to assess changes for best results ng (Nelson et al. 2011, p. 276). The IDT will identify the patients at risk and will intervene with a patient-centered-care, skin assessment (Plan), the team will then implement the changes, and interventions, using the redistributing pressure surfaces (DO), as a follow up, the team will evaluate collected data from check list and shift reports (Study), and implement what was learned from using redistributing pressure surfaces

It is a useful way to identify those patients who are at high risk for pressure injuries.23Based on the risk assessment score, a plan is then established to suit the patients’ individual care needs. For example, patients who score a mild risk, may require frequent turning schedules, maximal remobilization, a pressure reduction support surface, management of moisture, nutrition, and friction/shear, etc. For those at very high risk, a static air overlay or a low air loss bed may be needed.24 These recommendations as identified by Braden and Bergstrom24 allows for clinicians to limit interventions to those patients who are at risk, to reserve intensive and costly interventions to those who are in most need, as well as address specific problems that contribute to that level of risk. Following the admission assessment, reassessments should be done 48 hours later and at periodic intervals thereafter depending on the rapidity of changes in the patient’s health condition and depending on the health care setting. 23 In a long term care facility for example, 80% of residence who develop pressure injuries do so within 2 weeks of admission, and 96% do so within 3 weeks of admission. Therefore, in this type of setting, an appropriate schedule for a reassessment may be different, i.e every 4 weeks followed by quarterly assessments. 23 In an intensive care unit, reassessments may be

The fourth study by Iranmanesh, S., Rafiei, H., & Sabzevari, S. (2012) is a Level II clinical trial, which identifies the connection between the Braden Scale assessment and critically ill patient admitted to the trauma ICU. The study monitored patients admitted to the ICU over a three month period which were assessed using the Braden Scale assessment tool. In this study, it was found that the Braden scale was effective in predicting patients at risk for pressure ulcers. The Braden Scale was performed three times a day by trained clinical nurses on eight-two patients who were admitted to the ICU and had no pressure ulcers at the time of admission. Of those admitted eleven patient developed pressure ulcers. The findings of this study found that

VAS is formed by a 100 mm horizontal line anchored on both ends, with the left end denotes the minimum score and the other end as the maximum score. VAS anchors, time period of reporting and instructions of use vary depending on the intended use of the scale. For pain intensity, the left-most anchor indicates “no pain,” which is a score of 0 and the right-most anchor indicates “worst imaginable pain,” which is a score of 100 on a 100 mm scale. Pain VAS is self-completed by the participant where they are asked to draw a line perpendicular to the VAS line at the point that represents their pain intensity. Value of pain intensity is obtained by measuring the distance from the “no pain” anchor to the perpendicular line drawn by the participant.