Pressure Ulcer Prevention in Hospital Pressure Ulcer is localized injury to skin and underlying tissue over bony prominence due to pressure or combination of shear and friction. Pressure ulcer not only extends hospital stay but also causes serious complication for example; pain, delay in functional recovery, serious infection, sepsis and mortality. Pressure ulcer is preventable but the problem is rising in health care facilities. Thus identifying patients at risk and implementing preventive strategies is important aspect. Background Each year, 60,000 people die worldwide due to pressure ulcer related causes. Pressure ulcer has been nursing concern for many years and remains major health problem. Treating pressure ulcer is not only costly but increases sickness and death rate as well. If existing pressure ulcer is not reported through skin assessment at the time of admission by health team member but later found then such case is consider as hospital acquired pressure ulcer. There are several risk factors which could impair microcirculation system and result development of pressure ulcer. In United States, a study was conducted which demonstrated pressure ulcer can be avoided by implementing risk factor assessment scales and regular turning of patients. Several risk factors such as diabetes mellitus, sepsis, older age, dry skin, malnutrition, impaired mobility, incontinence and history of pressure ulcer are correlated with pressure ulcer. Nurse plays major role in
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,
Although the situation was quite challenging, it provided me with some useful experiences for the future practice. I understand that all institutions should have a policy for documenting the assessment of patients, including pressure ulcers (Morison 2001). I have come to be familiar with the homes assessment policy using the Sterling Pressure Sore Severity Scale and most importantly I have learned that by using a universal assessment tool it supports a systemic and consistent approach to pressure ulcer evaluation. This therefore supporting continuity of care.
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).
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
To start the search for evidence within University Hospital, questions were asked in regards to pressure ulcers. Monthly updates are often sent out via email from the wound care team to keep everyone up to date on knowledge. While there was informative numbers within those updates, this information falls short according to Moore, Webster, & Samuriwo (2015). The main limitation of the study is the lack of a control group in pressure ulcer prevention and treatment. There is no clarity in the specific criterion that contributed to improved clinical outcomes. Teams used more than one method in the research project. Also, there is no study that meant the inclusion criteria in the random clinical trials. The lack of standardized
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.
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
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
According to Stockhausen & Conrick (2002), “Learning how to critique research articles is one of the fundamental skills of scholarship in any discipline” (p. 38). Burns & Grove (2011) found “An intellectual critical appraisal of a study involves a careful, complete examination of that study to judge its strengths, weaknesses, meaning, credibility, and significance for practice” (p. 419). The extent, amount and nature of publications accessible today by different means implies it has become crucial to prepare students and practitioners to judge the trustworthiness and helpfulness of published research (Stockhausen & Conrick, 2002, p. 38). The purpose of this report is critiquing a qualitative research article on pressure ulcers.
Pressure ulcer prevention has been the nursing worry for many years. Florence Nightingale in 1859 wrote, “If he has a bedsore, it’s generally not the fault of the disease, but of the nursing” (Nightingale, F). People may think pressure ulcers associated with poor nursing care. Prevention of pressure ulcers is a multidisciplinary responsibility; however, nurses have a primary role. Patient participation in prevention of pressure ulcers (pup) care has been shown to result in improved patient safety and satisfaction with care ((Weingart, S.N., Zhu, J., Chiappetta, L., Stuver, S.O., Schneider, E.C., Epstein, A.M. 2011). Purpose of the study includes the nurses and patients partnering together with prevention of pressure ulcers (pup) may be an effective strategy for reducing pressure ulcers (PU) among at-risk individuals. So the research team developed a pressure ulcer prevention care bundle (PUPCB) targeted at both patients and nurses, encouraging patient participation in PUP care with three simple evidence-based messages: 1) Keep moving; 2) Look after your skin; and 3) Eat a healthy diet. Messages were provided to patients with a poster, brochure and DVD. Nurses had training regarding how to be companion with patients in pressure ulcer prevention (Roberts et al. 2016).
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 ulcer is a localized injury to the skin and underlying tissue, usually over a bony prominence, as a result of pressure or in combination with shear and/or friction (Potter& Perry, 2014, p. 1251. Risk factors for pressure ulcers include, impaired sensory perception, impaired mobility, and altered level of consciousness, shear, friction, moisture and nutrition (Potter& Perry, 2014, p. 1251-1256). The incidence of pressure ulcer is very high in hospital and nursing home setting as indicated by Potter and Perry (2014) which reported that “pressure ulcers have a high prevalence rate in all health care setting and it is estimated that one in four individuals within the Canadian health care system has some issues with
One regulatory standard that influences nursing practice for pressure ulcers is the Deficit Reduction Act (DRA) of 2005, for discharges occurring on or after October 1, 2008, hospitals will not receive additional payment for cases in which one of the selected conditions was not present on admission. If a pressure ulcer was not present upon admission but occurred after admission, a hospital will not receive additional payment related to this hospital acquired condition because it comes have been prevented (USCMMS, 2016). When hospitals lose financially, it impacts staffing and patient care. Hospitals are now more proactive about preventing pressure ulcers, nurses document the condition of a patient’s skin upon admission, we have skincare/wound nurses that help us to apply evidenced based practices in order treat and prevent pressure