Pressure Ulcers And The Acute Care Unit : Making A Change

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 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.

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

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 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,

The hospital acquiring data on the above indicators of pressure ulcer incidence, prevalence of restraints,

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

Implementing prevention plan for pressure ulcers would become a marker for a quality of care, which ultimately leads to improvement of quality by making healthcare more reliable, accessible, patient-centered and safe. As a part of the pressure ulcer prevention plan effort, one should regularly assess the pressure ulcer rates and practices. Steps to regularly monitor are: An outcome which can be pressure ulcer prevalence or incidence rates. Minimum one to two care processes (ex: skin assessment). Key aspects of the organizational structure to support best care practices. Below are the steps that will help to develop processes and measures for assessing pressure ulcer and practices.

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

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

Preventing pressure ulcers is important ,because as they are open wonders, and as such they hold a high risk of infection that can easily lead to things such as blood poison over time. If left untreated or noted patient's health can turn of stable to critical in a matter of hours or days depending on the severity of the sour.

Pressure ulcers are staged rated on severity (stage I- stage IV, stage IV including damage to muscle and possibly joints). The deeper and more severe the pressure ulcer is, the more difficult treating the ulcer can be, costing the hospital more money per patient case. In one study, conducted in the United States, it was found that treatment may cost up to seventy thousand dollars per pressure ulcer in the hospital setting and up to eleven billion dollars annually (Damask, K. 2015). According to the article Drugs & Aging, many patients with severe ulcers, such as a stage three or four, develop chronic wounds that may even result in death as a complication (Jaul, E. 2010). Prevention is the key in regard to pressure ulcers. Therefore, quality improvement research can improve hospital protocols, which may/may not be in place related to pressure ulcers, and improve patient outcomes.