Pressure Ulcer Prevention

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,

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

Most mobile patients are able to reposition themselves, while others who are critically ill are not able to feel or respond to pain. Therefore, nurses need to assess those patients in repositioning to decrease the risk of developing pressure ulcers (REF).

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

Pressure ulcer develops as a result of the skin that is over bony prominence. The pressure impairs blood flow leading to tissue necrosis and ulceration. Pressure ulcer can develop in several areas of bony prominence of the body such as the sacrum, greater trochanter, ankles, shoulders, head and ischia. It can develop quickly and difficult to treat, it ranges from mild to skin redness to severe tissue damage, development of infection and damage to muscle. Older people are most at risk due to thin and fragile skin,

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.

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

Franks, P. J., & Moody, M. (2007). Randomized trial of two foam dressings in the management

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

Studies have pointed out that nurses possess a significant role and extensive knowledge in pressure ulcer prevention. Instructive programs in the hospitals give great learning to nurses about the preventive and treatment techniques for

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

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 Prevention (PUP) is a national initiative for all hospitals. Medicare estimates an average of $146 million being spent annually for hospital acquired conditions which include pressure ulcers (Kandilov, Coomer, & Dalton, 2014). Hospital acquired pressure ulcers are among the top five adverse events reported today (Gillespie, Chaboyer, Kent, Whitty, & Thalib, 2014). Medicare will stop paying for hospital acquired conditions therefore prevention is the key (Kandilov, Coomer, & Dalton, 2014). Best practice guidelines advocate routine repositioning of patients however the studies were not based on RCT’s and were conducted well over 20 years ago, and before the improvement of mattress that are used in hospitals and long-term care facilities (Gillespie, Chaboyer, Kent, Whitty, & Thalib, 2014). The purpose of this assignment is to critique a problem (repositioning patients to prevent pressure ulcers) related to the nursing profession that will allow the reader to identify, appraise, and synthesize studies in order to draw a conclusion from the data collected. The systematic research review (SRR) “Repositioning for pressure ulcer prevention in adults” by Gillespie, Chaboyer, Kent, Whitty, & Thalib, (2014) will be critiqued in this paper by describing the relevance of preventing pressure ulcers; the rigor of the studies used; critiquing the levels of evidence of the studies; describe the clarity with which the studies are

The patient has suffered a stroke which has affected his mobility therefore this has become troublesome for the daughter as she works various shift patterns and is unable to give her father the level of care the patient requires, with regards to her father’s personal care which is affecting the patients pressure areas. Therefore, the patients pressure ulcer has increased in size and depth. According to Mallah, Nassar and Badr (2014) pressure Ulcers (PUs) are associated with high mortality and morbidity, in addition to being costly to the health care providers. The presence of pressure and shear forces both excess moisture and dryness can exacerbate skin breakdown, making a patient more susceptible to a pressure ulcer (Sibbald, Goodman, Norton, Krasner, & Ayello,