Integrative Research On Patients With Venus Leg Ulcers

In the following case study, the author will discuss the issues surrounding a seventy-year-old female with a chronic neuropathic ulcer on the sole of her right foot and the rationale and implications of

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,

Treatment of a pressure ulcer costs the NHS more than £3.8 million, despite the progress and management of pressure ulcers 700,000 people are still affected this remains to be a significant problem for health care professionals (NHS Improvement, 2016). Therefore, this case study will enumerate the cause, treatment, prevention and risk factors of a pressure ulcer in relation to a patient who is suffering from a grade three-pressure ulcer to his sacrum and therefore requires long-term care from the district nurses. Pressure ulcers can occur more commonly on the sacrum or heels in any health care settings (Clarkson, 2007). Although more prevalent in the elderly, people of all ages are at risk of developing a pressure ulcer

Nursing interventions play an important part in the reduction of pressure ulcers. A nurse can help to reduce the risk of pressure ulcers by promoting activity, carrying out skin inspections and assessments, and by using pressure relieving devices (Lynn, 2005). Some patients may fear being dropped when moved using equipment (Rogers, 1999), thus it is important for the Nurse to communicate with the patient, this way the Nurse can explain how the equipment works and the patient can express any concerns that they may have. It is important to remember that not all patients like lifting equipment and

I have significantly developed my skill in wound care assessment and dressing, in developing this skill I now recognize the importance of documenting each dressing. Morison (2001) supports this in saying that by detailing pressure ulcer assessment it provides a basis for deciding the effectiveness of the current treatment.

Fortunately, according to Chan et al., (2008), 95% of pressure ulcers can be prevented and nursing care is believed to be a primary method of preventing pressure ulcer development. Research was conducted on accredited search databases such as CINAHL, Nursing Resource Center and OvidSP on prevention measures for pressure ulcers. A number of credible evidence based research was found that supported the nursing intervention of

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

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

is not receiving enough nutrients such as protein and vitamins that are crucial to wound healing, which impedes healing of the pressure ulcers (Myers, 2012). Last but not least, he has sexual dysfunction that can be detrimental to his psychosocial well-being. He is physically unable to achieve erection and orgasm. Appendix A is provided at the end of the paper to show an example of nursing care plan for physiological issues.

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

The primary goals for conducting nursing research are to generate new knowledge to promote positive outcomes for patients, enhance quality and cost-effectiveness of care, improve the healthcare delivery system, and validate the credibility of the nursing profession through evidence-based practice (Schmidt & Brown, 2012). The purpose of this paper is to explore the practice-related problem of pressure ulcers and the importance of the problem in the nursing profession.

Pressure ulcers occur over bony prominences when skin is compressed for long periods of time, affecting the blood supply to certain areas, leading to ischaemia development (Waugh and Grant, 2001). Compression of skin is caused by pressure, shearing and friction, but can also occur due to pressure exerted by medical equipment (Randle, Coffey and Bradbury, 2009). NICE (2014) states that the prevalence of pressure ulcers in different healthcare settings in December 2013 was 4.7%, taken from data available for 186,000 patients. The cost of treating ulcers can vary depending on severity from £43 up to £374 (NICE, 2014). Evidence based practice skills are essential in nursing as it allows the best available evidence to be used to improve practice and patient care, while improving decision-making (Holland and Rees, 2010). I will be critiquing two research papers; qualitative and quantitative, using a framework set out by Holland and Rees (2010), and will explore the impact on practice. Using a framework provides a standardised method of assessing quality and reduces subjectivity.

The qualitative research article selected for critique is the study by Athlin et al. (2009), with the title of, “Factors of importance to the development of pressure ulcers in the care trajectory: perceptions of hospital and community care nurses”. This study looked at contributing factors promoting the growth or relapse of pressure ulcers, and how the nurses working in hospitals or group care, comprehend them in the care trajectory.

Pressure ulcer prevention has been the nursing worry for many years. Florence Nightingale in 1859 wrote, “If he has a bedsore, it’s generally not the fault of the disease, but of the nursing” (Nightingale, F). People may think pressure ulcers associated with poor nursing care. Prevention of pressure ulcers is a multidisciplinary responsibility; however, nurses have a primary role. Patient participation in prevention of pressure ulcers (pup) care has been shown to result in improved patient safety and satisfaction with care ((Weingart, S.N., Zhu, J., Chiappetta, L., Stuver, S.O., Schneider, E.C., Epstein, A.M. 2011). Purpose of the study includes the nurses and patients partnering together with prevention of pressure ulcers (pup) may be an effective strategy for reducing pressure ulcers (PU) among at-risk individuals. So the research team developed a pressure ulcer prevention care bundle (PUPCB) targeted at both patients and nurses, encouraging patient participation in PUP care with three simple evidence-based messages: 1) Keep moving; 2) Look after your skin; and 3) Eat a healthy diet. Messages were provided to patients with a poster, brochure and DVD. Nurses had training regarding how to be companion with patients in pressure ulcer prevention (Roberts et al. 2016).

This article includes many peer review studies to see the trend of nursing care in relation to skin care and pressure ulcer prevention. It looks at quality of assessment, implement, and plan of care before and after admission.