Pressure Ulcers: A Case Study

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.

The authors were concerned with health-related quality of life (HRQL) and how pressure ulcers impact the patient's subjective experience of care, because overall health care outcomes may be influenced by the interaction between disease burden and patient compliance. Thirty adult patients in hospital, rehabilitation, or community care in England and Ireland were recruited for the study. Inclusion in the study required being under the care of a tissue viability nurse.

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

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.

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

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.

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

"Hospital-acquired pressure ulcers were shown to be an important risk factor associated with mortality," per Dr. Courtney Lyder, of the UCLA School of Nursing. "It is incumbent upon hospitals to identify individuals at high risk for these ulcers and implement preventive interventions immediately upon admission." Pressure ulcers, also known as bedsores often occurs when patients have limited mobility and unable to reposition themselves in bed causing injury caused by pressure, friction 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

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

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

Our unit conducted a research study how to prevent skin breakdown and pressure ulcers. Many risk factors affect the skin break down in my unit such as age, immobility, incontinence, inadequate nutrition, sensory deficiency, diabetic. We should perform daily skin assessments for high-risk patients. Our unit used the Barden scale for evaluating pressure

Kane, 2007 revealed a correlation between HAPUs and advanced mortality in a hospital as well as within 30 days of hospital discharge (Kane, 2007). CMS and professional organizations have issued clinical practice guidelines for HAPU prevention for decades. However, health care organizations continue to struggle to implement these recommendations when it comes to patient care (Kane, 2007). Many organizations are creating interventions to prevent HAPUs in acute care settings, but there is little evidence as to which of these interventions will effectively change routine clinical practices (Hulscher, 2003). Successful HAPUs prevention requires building a culture of diligence, expertise, and cooperation in which health care providers recognize HAPUs prevention as a high priority. The best defense against pressure ulcers is an evidence-based prevention plan that is implemented and revived based on the patient’s response to care (Society 2012).

According to the abstract of the article, it states that the purpose of this article was to prevent pressure ulcer in two Saudi intensive care units by studying the effectiveness of a pressure ulcer prevention bundle. this information was presented clearly and concisely because it acknowledges the problem in the beginning of the article, so the readers can know what the study was conducted about. The focus of the article was based around two hypotheses, the first hypothesis stated that “Saudi ICU patients who receive the PU prevention bundle will have a decreased PU incidence of 25% or greater compared to patients who received standard care”. The second parted of the hypothesis stated “Saudi ICU patients who received the PU prevention bundle