Pressure Ulcers As An Area Of Skin And The Tissues

Pressure ulcers are a good way for the BSN prepared nurse to teach and educate RNs with an associate degree or diploma and other healthcare staff involved in patient care. This can be accomplished by introducing evidence-based practice information to them. They can be taught how to use to the Braden Scale effectively. They can teach others how to correctly stage and document pressure ulcers. Another important factor is stressing the importance of positioning, pressure-relieving devices, skin care and protection, and nutrition (Agency for Healthcare, 2009).

Furthermore, another factor creating a risk for pressure ulcer development is malnutrition. Wysocki (2002) observed that 10 to 50% of hospitalized patients are malnourished. Nurses should be alert to inadequate nutrition and its effects. Also, Cobb and Warner (2004) noted that when thirty percent of weight is lost, spontaneous pressure ulcers begin to develop, and prevention strategies might not work. In addition, urinary and fecal incontinence are also significant risk factors. Incontinence results in excess moisture, and irritation of the skin. The nurses and assistive personnel in XY hospital often do not assist their incontinent patients for long periods of time, and they do not utilize the available skin protectants. Studies confirmed the effectiveness of no-rinse cleansers and moisture barrier creams, and found that they were less likely to harm skin integrity than soap and water (Thompson, et al., 2005). The findings also advise that checking the patients for soiling every two hours adds to the effectiveness. Although not all pressure ulcers are preventable and curable, the literature provides supportive evidence that appropriate prevention protocols decrease the incidence of stage one and two

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

A pressure ulcer is a localized injury to the skin usually over bony prominence, as a result of pressure, or pressure in combination with shear. It is estimated that 5 to 10 percent of patient admitted to the hospital acquire a pressure ulcer and it result in increased suffering, morbidity and mortality. The policy titled Pressure Ulcer Prevention and Managing Skin integrity provides direction for the nurses to prevent the development of pressure ulcer. It

Pressure Ulcers are a common issue for hospitals and long-term nursing facilities nationwide. Annually an estimated cost of $143 million is spent on hospital acquired conditions which include pressure ulcers (Kandilov, Coomer, & Dalton, 2014). Hospital acquired pressures ulcers are among the top five conditions (Kandilov, Coomer, & Dalton, 2014). Ultimately the first line of defense is prevention and therefore this paper will focus on a clinical practice guideline for deterring the pressure points that progress tissue breakdown and patient harm.

Pressure ulcer prevention requires a team effort, involving physicians, nurses (including wound, ostomy, and continence nurses), dietitians, and physical therapists. Studies have demonstrated that comprehensive pressure ulcer prevention programs can decrease incidence rates, although not to zero. For optimal effectiveness, pressure ulcer prevention must begin as soon as patients enter the

Pressure ulcers often occur in hospitals and nursing homes (Ayello. A. E., 2012). As a result, the patient’s stay is extended and their medical bill inflates, in addition to their quality of life feeling diminished by the pain and infection (Ayello. A. E., 2012). Prevalence rates for pressure ulcers exist by 11.9% in acute care, 29.3% in long-term acute care,

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

Repositioning is also an essential recommendation for the prevention and treatment of pressure ulcers. It is important to determine the repositioning frequency based on the patient’s “tissue tolerance, level of activity and mobility, general medical condition, overall treatment objectives, skin condition and comfort” (EPUAP, NPUAP, & PPPIA, 2014). Repositioning initiates pressure relief and pressure redistribution. When repositioning, “the patient should not be positioned on bony prominences with existing non-blanchable erythema” (EPUAP, NPUAP, & PPPIA, 2014).

Pressure ulcers, also known as pressure sores, bedsores, and decubitus ulcers, result from pressure or shear friction and pressure that cause skin and underlying tissue to breakdown (Pamaiahgari, 2014, p.1). This is commonly seen over bony prominences such as the sacrum or the heel. Pressure ulcers prove to be an issue for the patient and require the determination of best practice to prevent the pressure ulcer and the complications that can accompany it. Pressure ulcers can be infected, increase in size, odor, and drainage, have necrotic tissue, be indurated, warm, and painful (Lewis et. al, 2014, p.184). Furthermore, untreated pressure ulcers can lead to more serious conditions such as cellulitis, chronic infection, sepsis, and possibly death (Lewis et. al, 2014, p.184). Recurrence of pressure ulcers

The authors concluded that pressure ulcers will be reduced if patients, 65 years and older repositioned every three hours, using 30° tilt. Pressure ulcers are very common, costly, and preventable. It affects the patients negatively. One of the factors that predisposes to the development of pressure ulcers is immobility. It remains a problem, but the problem is preventable, so the author stated that it is now time to reconsider this prevention practice to reduce this preventable problem in the health care

Older adults are vulnerable to pressure ulcer due to different factors. It is very common among older population especially in long term care facility. It is important for nurses to assess the client on a daily basis to prevent pressure ulcers from developing because once a pressure ulcer develops, it is very challenging to treat. (Kozier et.al., 2014 p. 1005).

According to the Center for Medicare & Medicaid (CMS), all LTCF must work to reduce the incidence and prevalence of pressure ulcers. All the facilities are expected to follow provided guidelines and procedures to prevent the occurrence and/or reduce the severity of pressure ulcers in high risk residents. The guideline state that the facility must first ensure that a resident that enters the facility without pressure sores does not develop pressure sores unless the individual’s clinical condition demonstrates that they were unavoidable. Secondly, it should promote the prevention of pressure ulcer development through the use of preventative measures and devices. Thirdly, it must promote the healing of pressure ulcers that are present (including prevention of infection to the

I`m happy to hear you want to expand your knowledge and learn about pressure ulcers as this is a common issue in healthcare. About 11 years ago I had a patient who was admitted to the rehabilitation center for treatment of a sickness. The client’s condition was settled and she was exchanged to a nursing home because the insurance would not cover the rest of her stay. It was normal that the patient would return home in a couple of weeks. Two weeks later, the patient was grumbling of somewhat coccyx agony. Amid visits, the patient was by all accounts lying or sitting similarly situated. Nobody associated that rather with urging the patient to get up, the staff had never repositioned her consistently. As a result of this negligence a bedsore

The largest organ of our body is our skin, and it can be very fragile as we age. However, medications, tanning, and illness can all play a part in the skin thinning as well. I believe education is the key to understanding the prevention of pressure ulcers. Hospital patients are at a higher risk for developing a pressure ulcer. All hospital patients should be screened on admission to see if they are at risk for developing a pressure ulcer. Patients that have pressure ulcers can have pain and discomfort at the sight. Many factors contribute to the development of a pressure ulcer. One would think it was just from not being turned every two hours. However, every patient is at risk for a pressure ulcer when they cannot move or change their position