Prevention Measures and Treatment Options of a Pressure Ulcer

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.

According to, the European Pressure Ulcer Advisory Panel (EPUAP), National Pressure Ulcer Advisory Panel (NPUAP) and Pan Pacific Pressure Injury Alliance (PPPIA) classification system (2014) pressure ulcers are categorised into four stages depending on their severity. Stage one: skin still intact with non-blanching, redness with swelling present. Stage two: the skin breaks open or forms a blister without slough and is usually tender or painful. Stage three: pressure sore becomes worse, slough may be present and extends into the tissue beneath the skin where subcutaneous fat may be visible but bone, tendon or muscles are not exposed. Stage four: pressure sore becomes very deep reaching into the muscle or tendon causing extensive damage with necrosis. However, pressure ulcer staging is dependent on visible skin characteristics therefore misclassifying pressure-related injury can remain undetected for days or weeks before a purple discolouration of the skin appears (Mallah, Nassar and Badr, 2014).

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

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

An interdisciplinary team of professional staff is a necessity to overcome the issue of pressure ulcer development among patients. Relevant stakeholders would include a nurse, nurse aide, dietitian, and a hospitalist. The primary responsibilities of the nurse consist of completing and documenting skin and risk assessments, monitor progress and/or changes in medical/skin conditions, report patient problems to the hospitalist, and work with the wound team

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

While nurses encounter patients with pressure ulcers in home care and acute care settings, they are mainly a problem with elderly adults in long term care facilities. This is because of decreased sensory perception, decreased activity and mobility, skin moisture from incontinence, poor nutritional intake, and friction and shear (Stotts and Gunningberg, 2007).

A recorded data from ClinStar of the past three months (November 2016 through February 2017) showed that nurses admitted about 126 patients to CCU with pre-existing pressure ulcers reported. On the other hand, about 28 patients were reported to develop pressure ulcers from stage I to stage IV in CCU. This collected data suggests that patients admitted to this CCU are at risk of harm. It compromises patient safety, reflects poor nursing care, and lowers standards of practice when benchmarked with other institutions. The quality improvement (QI) and performance management (PM) committee projected the numbers of pressure ulcer incidents for one year solely in this 18-bed CCU. If a proper strategy is not implemented soon, an estimate of 1512 patients may be admitted with pressure ulcers and about 336 patients may develop pressure ulcers per year on this unit.

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 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.

Introduction This literature review will define pressure ulcers, wound cleansing and irrigation. Also, the amount of pressure required to successfully irrigate wound will be discussed, whilst comparing two solutions tap water and normal saline. Blinding exercised by reviewed studies to conceal group

Patients get a pressure ulcer for a legion of rationalities. According to Alene Burke of Nursing Assistant Education, some of the elements why people get them which she cited from Nettina, S. (2009), are old age, deficient mobility, lack of moisture, and insufficient diet. Moreover, factors like neurological and other physical problems, friction and shearing, bed and chairs with wrinkled linens or hard objects and pressure ulcers in the past may similarly predispose pressure ulcer. This observations implies that in nursing care pressure ulcers are prospected as negligence, however it is arrogated that pressure ulcers are avoidable on the condition that prime level of care is continuously rendered to patients and residents. (Burke 2010).