The pressure ulcers are a serious and significant health care problem. It not only cause pain, slow recovery from the sick skin condition and prolonged hospital stay but also increase health care costs and nursing time. It occurs in patients of all age group. According to the statistics, it cost $9.1-$11.6 billion and 2.5 million people affect Nation wild each year ( Are We Ready for This Change? | Agency for Healthcare ... n.d.). The skin lesions cause patient suffering from pain, and the risk for infection. In this essay, the student will present a pressure ulcer prevention program (PUPP). Discussing the purpose of the program, the target population, and the benefits of the program associated with the cost. At the final, the student will evaluate the possibility to implement the program.
Pressure ulcer prevention program is an interdisciplinary quality improvement initiative. It is designed to assist nursing home
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Be sure all shifts are represented. Risk assessment to all residents every shift. Educate all staff the knowledge of pressure ulcer including risk factors, prevention method. Ensure that all the staff, understand the guidelines, policies and role of responsibility. Empower them to organize their shifts and tasks, assure interventions are implemented and communicated. Use evidence-based pressure ulcer prevention guidelines in the clinical practice. The electronic computer support system create a resident-tailored protocol information into the system included (1) Record the preventive materials for easy entrance. Such as foam mattress availability. (2) Resident pressure ulcer risk assessment, pressure ulcer and skin assessments. (3) Information on evidence-based interventions and referrals to other types of care staff such as dieticians. Nutrition interventions have been found to reduce
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.
Now, the quality improvement department will need to determine what processes can be modified to improve outcomes. For example, if they see an increase in pressure sores and prevalence of restraints. They could use computerized charting and order entry, along with the evidence-based guidelines, to identify specific groups of patients who are vulnerable to developing pressure ulcers or closely monitoring use of restraints. With early identification, automatic orders for preventive interventions can be implemented quickly. With the assistance of the automated consults and orders, the appropriate equipment, the interdisciplinary task force, continuing education, and monitoring, the hospital system would be able to reduce unnecessary use of restraints and hospital-acquired pressure ulcer prevalence rate (Cherry & Jacob, 2010).
Roles of the Registered Nurse (RN) are ever changing where it is key to continue to educate for the protection and well being of the patient. Pressure ulcers have become a main issue in healthcare in an attempt to lower cost as well as prevent further morbidities and complications for the patient. According to the National Institute of Health (NIH) a pressure ulcer is defined as an area of skin that breaks down when something keeps rubbing or pressing against the skin. An increase in immobile and elderly patients has increased the risk for the development of pressure ulcers. The education and prevention of pressure ulcers should be implemented as a key goal for a nurse during the care of a patient.
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 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.
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).
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
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).
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.
Pressure ulcers continue to be a prevalent issue in the health care system and causes “pain, slow recovery from morbid conditions, infection and death” (Kwong, Pang, Aboo, & Law, 2009, p. 2609). In the field of nursing turning and repositioning patients is a well-known nursing intervention to prevent development of pressure ulcers. However, many hospitals and facilities still neglect to apply this as a standard policy. This gives room for nurses and nursing aides to overlook the importance of this intervention resulting in increased pressure ulcer development. The purpose of turning and repositioning patients is to prevent oxygen
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
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 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.
2. Working according to the agreed ways means following the organisation’s policy and procedures in relation to pressure areas. It also means following the individual care plans and respecting the instructions in place. For example making sure a resident is turned every two hours, applying Cavilon cream on areas; fill in turning charts, prompt fluid intake. Under the duty of care a care assistant must always be aware of and raise concerns regarding possible pressure areas. Always record information in care plans accurately and in confidentiality.
The main priority of the Veterans Affairs system is getting zero pressure ulcers. To achieve this goal, staff must be knowledgeable of the basic principles of skin disease, preventions, and treatments when providing care for the elderly patients. They provide education and training on the current evidenced-base practice on pressure ulcer preventions. The approach that has been effectively used is the care bundle (AHRQ, 2014). We