Marguerite DiPietro Practice for Nursing Research 09 July 2015 As I continue my studies in the nursing field, I find that I have always been interested in the prevalent problem of pressure ulcers that affects health care facilities on a daily bases. Specifically, I am curious about the role of the nurse in terms of prevention and care of pressure ulcers. I have decided to chose this issue because I find it both interesting and important as I continue my studies. It is especially important as I transition in to more of a clinical setting. The research I can gather from this topic can be used as I start to gain more clinical experience and patient interaction. I hope to learn more about what I can do myself to help with this widespread problem. …show more content…
Instead of having an experimental component the article goes into depth about the different nutritional benefits patients should be getting. Because those in critical care are ill and in a compromised position, preventing pressure ulcers can be even more challenging. This article proposes however, that nutrition is essential in slowing down the formation of pressure ulcers and increasing the efficiency of wound healing. Though the article is not an experimental study it is reliable in the sense that all of the information is valid. The article defines important terms, talks about the specific nutritional benefits certain food groups contain and how this all relates to preventing and treating pressure ulcers. The research integrity of this article is strong because it is not based on biased opinions but rather it is based on factual information applicable to the critical care patients. I do find that because there isn’t any comparative study being done that the article has its limitations. It would be interesting to weigh the benefits of the nutritional component with the damaging effects of not doing anything at all. The key findings of this article include the importance of screening patients to find out their nutritional status as well as getting them in touch early with a registered dietitian. This will help to figure out the appropriate feedings the patients need to be administered including beneficial micronutrient and macronutrient supplementation. Both of these supplements promote the healing of wounds and are helpful when it comes to making improvements for the critical care patients and their nutritional status. Article two focuses on the effects pressure mattresses and overlays have in terms of the prevention of pressure ulcers. It is a quasi-experimental study. The study took place in a
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,
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.
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
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).
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
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
While University Hospital is already on the brink of completely preventing pressure ulcers I would still recommend implementing all of the current practices but also add new additions to the team. Currently, we have a wound care team that diligently treats at risk and affected patients. Adding a nutritionist into the team to guarantee treatment from within along with prescribed medications. This will make the team and the strategies multidisciplinary. In addition to that, each treatment should be customized for each patient in regards to cost options and best treatment for their health. The project would also have to be performed repetitively without error to ensure that it is actually helpful. Patients’ skin should continue to be examined thoroughly in common places where ulcers could arise, the standardized pressure ulcer risk assessment should be used, and the proper care should be distributed once evaluated. The team should continue to record its progress and also provide company update emails to inform the facility, as well as send the appropriate data to the higher ups for public posting.
education for the staff on what signs to look for concerning pressure ulcers as well as education on the laws and
Pressure ulcers are a good way for the BSN prepared nurse to teach and educate RNs with an associate degree or diploma and other healthcare staff involved in patient care. This can be accomplished by introducing evidence-based practice information to them. They can be taught how to use to the Braden Scale effectively. They can teach others how to correctly stage and document pressure ulcers. Another important factor is stressing the importance of positioning, pressure-relieving devices, skin care and protection, and nutrition (Agency for Healthcare, 2009).
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
Braden scale (Braden & Makelburts, 2005) use in hospitals allows nurses to identify patients at risk for pressure ulcer based on their sensory perception, mobility, activity, moisture and nutrition. Although the Braden scale is a useful tool but healthcare administrations has yet found the best method to eliminate pressure ulcers or bedsore in intensive care units. The use of foam dressing will be introduced to the intensive
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
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.
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 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.