Pressure Ulcer Case Study Essay

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.

A common health concern seen in the elderly, especially those within institutions, are pressure ulcers. A pressure ulcer is defined as a localized injury to the skin or underlying tissue that occurs when something keeps rubbing or pressing against the skin. Pressure on the skin causes a decrease of blood flow to that area and as a result, an ulcer may form because of the skin dying due to the lack of blood in that region. They generally occur over bony prominences such as, the buttock, elbow, hip, heel, back of the head and ankles. An ulcer has a greater chance of forming if the person uses a wheelchair or stays in bed for a long period 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

Pressure ulcers are a problem and can lead to poor patient outcomes as well as hospital fines. Evidence based studies have shown that “the average cost of care in an acute care hospital for a patient with a stage III or stage IV pressure ulcer reported by the Centers for Medicare & Medicaid Services (CMS) is $43,180” (Jackson, 2008). Pressure ulcers and other skin breakdowns are among the most significant adverse events causing distress for patients and their care givers and compromising patients’ recovery from illness or injury (Gardiner, 2008). It is the tasks of nurses to ensure prevention of these complications is part of the daily care regimen.

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.

While nurses encounter patients with pressure ulcers in home care and acute care settings, they are mainly a problem with elderly adults in long term care facilities. This is because of decreased sensory perception, decreased activity and mobility, skin moisture from incontinence, poor nutritional intake, and friction and shear (Stotts and Gunningberg, 2007).

In order to facilitate understanding of process data and outcome data, this essay will focus on the context of hospital-acquired pressure injury (PI). PI, also referred to as decubitus ulcers, bed sores or pressure sores, is defined as soft-tissue ischaemic necrosis localised in an area caused by prolonged pressure higher than the capillary pressure with or without skin tear or breach, related to posture over a bony prominence. The aetiology of pressure ulcers include: (1) pressure – weight of the skin against contact area; (2) shearing; (3) friction; (4) moisture; (5) position of the patient; (6)immobility; (7) neurological factors; (7) metabolic and nutritional factors; (9) oedema; and (10) age. PIs affects not only in infirmed older people,

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.

Pressure ulcer or bedsores as it is called is commonly referred to as very prevalent among high-risk patients, especially those confirm to hospital or long-term care setting. These individuals may be adults, elderly, frail, poorly nourished, and with comorbid illness. The objective of this assignment Is to Provide Awareness to my PICOT question which will be a quantitative research and will be supported by evidence-based research and obtained by systematic review from many database searches.

Pressure ulcers have a direct effect on patients and health care organizations. These effects will be discussed below, first looking

There is no policy or procedure in place to assess a patient’s risk for developing pressure ulcers. Nursing staff are alerted to areas of skin impairment, only by a patient or caregiver after an ulcer has developed. Once a pressure ulcer is discovered there is no standardized method of treatment to ensure appropriate wound healing. There is no standardized educational tool in place to inform a patient on the principles of pressure ulcer development and

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

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

“Pressure ulcers are caused when an area of skin and the tissues below are damaged as a result of being placed under pressure sufficient to impair its blood supply.” as defined by the National Institute for Health and Care Excellence (as cited in Payne, 2016, p. 12). I had never really known much about pressure ulcers before nursing. The frequency to which pressure ulcers can occur, and the level of severity they can develop was shocking to me. This is the main reason this topic interested me. The article “Strategies to support prevention, identification and management of pressure ulcers in the community” by Drew Payne, focuses on community nursing and provides information on how to identify patients at risk, on pressure ulcer