Pressure Mapping

Outcome 1 understand the anatomy and physiology of the skin in relation to pressure area care

is important to make sure for the patients and the financial aspect that these do not happen. The care of a pressure

The CQC guidance about compliance Essential standards of quality and safety covers pressure care in-

Pressure Ulcers affects patients the older patients due to the problem of immobility. A pressure

The worse possible outcome of a pressure ulcer is death, with an approximation of 60,000 patients dying each year as a direct result of a pressure ulcer (Stotts & Gunningberg, 2007). This is significant to nursing practice because if we can prevent more pressure ulcers from occurring, we can dramatically improve patient outcomes, patient family and satisfaction, and even prevent the death of a loved one.

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

Nurses need to realise what they are looking for when performing skin assessments for patients. A study conducted by Thoroddsen et al (2013), found that out of 45 patients that had pressure ulcers only 27 were correctly recorded in the patient’s records.

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.

Thus, the expected outcome is that there is prevention of skin breakdown relating to pressure ulcers during hospitalizations for patients.

Outcome 1: Understand the anatomy and physiology of the skin in relation to pressure area care

Despite advancement of technology, pressure ulcer continues to be a primordial in the health care system. Prevention of pressure ulcer remains an important issue in the health care facility. The critically ill ICU patient is the main target of this disease. Prevention remains the key for this problem. Some facility have standard policy for the eradication of pressure ulcer However the question is will the sacrum pressure ulcer formation be reduced in adult critically ill clients

According to Agency for Healthcare Research and Quality (AHRQ), 90% of all pressure ulcer related hospitalizations are due to secondary pressure ulcer diagnosis, 72% of patients are 65years or older and about 60,000 patients die each year as a result of a pressure ulcer. Some states legislation has declared secondary pressure ulcer as elderly abuse not covered by malpractice insurance. Fluid and

20. When patients are bed ridden they are rotated every 2 hours to prevent bedsores from happening. It's effective because when you are always in the same position it starts to cause a lack of blood flow. When you rotate them it takes the pressure off of the area and improves circulation-preventing bedsores.

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

At times it cans seem pointless to turn q2h, constantly check incontinent products, and do a thorough assessment of the skin to look for any redness. Comprehending the implications of immobility, allows for better during care and for a better experience for the resident on the whole. Nursing students should thoroughly look through a residents file to ascertain the extent of their mobility and any other factors that could lead to an increased risk of skin breakdown leading to pressure ulcers. Included in the daily organizational assessment plan, should be specific times for changing position in bed, changing the angle of tilt in a wheelchair, changing of incontinent products, reminders to apply lotion, reminders to utilize poseys and pillows, and any other strategy that can help to reduce the possibility of a pressure ulcer forming. My resident is completely dependent on health care professionals for her mobility and for the prevention of pressure ulcers. As such, I will take this reminder from these articles and be vigilant in performing her care in the best possible way to avoid skin breakdown which could lead to pressure ulcers. This includes using a slider sheet if I need to boost her in bed, applying lotions, remembering to change the angle go tilt while she is in her wheelchair, and using her heel poseys and pillows to protect bony prominences at