Pressure Ulcers And A Critical Care Situation

Pressure ulcers are the result of a deficient patient care in many health care organizations like

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.

Validity suggests the ability and degree of the method to measure the concept. More specific for the qualitative study, the criteria refers to credibility and trustworthiness. Credibility is a principle of trustworthiness and indicates the ability to answer the study question due to the quality of the research undertaken and reflecting the participants ' perceptions rather than the researcher own opinion and that the findings are trustworthy (Lincoln & Guba 1985, cited in Corbin & Strauss 2015).

As cited by Jarvis (2012, p.203), “the skin is the sentry that guards the body from environmental stresses and adapt it to other environmental influences.” Maintaining the elderly patient’s skin integrity requires a holistic care approach. As a nurse, one of our best practices is performing a thorough skin assessment of the whole body of our patients. A detailed head-to-toe skin assessment and clear documentation can help the interdisciplinary team in generating individualize plan of care. I perform a thorough assessment by inspecting the patient’s skin color, temperature, texture, moisture, and for presence of wounds. I ensure that the information I obtained from the skin inspection is clearly documented in the patient’s chart and plan of care, and any skin changes are communicated to the physician or nurse practitioner.

Validity refers to whether the research conducted is what it intended to be. Validity involves dependability, which means, a valid measure must be reliable. But, reliability doesn’t have to link to validity, a reliable measure is not required to be valid.

According to the Agency for Healthcare Research and Quality (AHRQ), 2.5 million patients are affected by pressure ulcers and incur costs anywhere from $9.1 billion to $11.6 billion per year in the United States (AHRQ, 2014). As of October 1, 2008, the Centers for Medicare and Medicaid Services (CMS) will not reimburse hospitals for cases in which the pressure ulcer was acquired after admission (CMS, 2008). Because of this high cost, the number of patients affected each year, and insurances no longer reimbursing hospital acquired pressure ulcers (HAPU), an accurate skin assessment upon admission is critical to reduce costs, ease pain in patients, and lower incidences of pressure ulcers. This paper will address what leadership and management skills and functions are required of a wound care nurse who identifies a problem with the accuracy of skin assessments on newly admitted patients.

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 ulcer prevention is a major task of direct care personnel in hospitals around the world. Even with evidenced-based polices currently in place at many facilities, patients still continue to develop pressure ulcers. Patients with pressure ulcers require the care of a multi-disciplinary team, ranging from nursing assistants to nutritionists to wound care physicians. Pressure ulcers are expensive to treat, can lead to infections and other illnesses, and sometimes cost patients their lives. A literature search was conducted of five articles related to pressure ulcer prevention in order to find a solution to implement on a medical-surgical unit at a local hospital. The proposed change was selected using Lewin 's Change Theory. The proposed solution was to train nursing assistants in assisting registered nurses (RNs) with monitoring patients ' skin and providing care to prevent the development of pressure ulcers. The pros and cons of this solution, required resources, costs of implementation, education required, and evaluation of the change were all discussed.

Furthermore, elderly people have very fragile skin—thinner and lack elasticity; making it very easy for them to get pressure ulcers. In skilled care and nursing home-type facilities, prevalence of pressure ulcers has been shown to range from 2.4 to 23 percent. These data are particularly difficult to generalize to other similar facilities; however, because of the highly variable ulcers increases with length of stay (Bergstrom, Allman, Carlson, Eaglestein, Frantz & Garber,

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.

I like your analogy of validity and reliability. It is very critical that the reliability and validity of the data collection tools that are used in qualitative research are validated because of the outcome of the research results. If the data tools are not valid, it could have a negative impact to the outcome of patients such as a treatment or drug that is being researched. The probability of harming a patient is high if a new treatment is incorrect.

Pressure injury, due to its high prevalence & probability, is nowadays seen as a patient safety issue internationally. As patient 's safety is paramount, a great importance is accorded to the issue. Even the performance of hospitals is benchmarked against the skin care quality, an attribute of quality care. This comparative essay outlines the evidence-based best practice recommendations to abate the risk of pressure injuries to patients in care. These recommendations, in essence, relate to the five research journal articles published recently.

With ongoing monetary restraints and increased federal regulatory requirements over hospital-acquired conditions, health care executives, leaders, and providers are increasingly challenged to keep patient safe and deliver quality patient care. In 2008, the Centers for Medicare and Medicaid Services (CMS) stopped reimbursing hospitals for cost associated with treating hospital-acquired stage III and IV pressure ulcers. According to CMS, Pressure ulcers and skin breakdown are serious patient care issue because most are considered reasonably preventable. Preventing skin breakdown and pressure ulcers are a high priority for acute care facilities. Health care facilities are engaging in evidence-based practices

Validity is often defined as the extent to which an instrument measures what it purports to measure. Validity requires that an instrument is reliable, but an instrument can be reliable without being valid. For example, a scale that is incorrectly calibrated may yield exactly the same, albeit inaccurate, weight values. A multiple-choice test intended to evaluate the counselling skills of pharmacy students may yield reliable scores, but it may actually evaluate drug knowledge rather than the ability to communicate effectively with patients in making a recommendation. While we speak of the validity of a test or instrument, validity is not a property of the test itself. Instead, validity is the extent to which the interpretations of