Problems of Pressure Ulcers

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.

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

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

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 during a hospital admission are preventable. Assessment and early intervention can stop skin breakdown before it begins. Many factors regarding Mr. J’s condition placed him at a high risk regarding nursing indicators. Mild dementia, recent fall and a fractured hip all require a high level of nursing care and indicates preventative practice. Upon assessment, precautions should be in place to deter further complications. The elderly are more

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.

Informative resources generated by project team needs to be disseminated to create awareness. Clinical benefits and outcomes needs to be discussed by the project team with medical staff. The feedback from the staff will fetch constructive outcomes to the project. “The prevention of pressure ulcer should become a standard part of yearly staff education fairs or other similar events (Berlowit et al. 2014)”. The unit without formation of pressure ulcers within 6 hours of admission should recognized and awarded for their hard work. Surveys must be provided to patients to assess their knowledge regarding prevention of pressure ulcers. That way patients and their families can be involved in the

Pressure ulcers are a commonly seen problem among elderly hospitalized patients. Despite new findings about the causes and approaches to treatment, the incidence of these wounds is still increasing. Scott, Gibran, Engrav, Mack and Rivara (2006) revealed that during the thirteen years of their study, the incidence of pressure ulcer development has more than doubled. As our elderly population becomes greater in number, and older in age, this problem is expected to escalate. It is of great importance for the patients as well as for the

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

The surveys were conducted between 1989 and 2005 predominantly in the US and showed an increase of 4.4% in number of nosocomial pressure ulcer prevalence rated with increase 6.3% in overall pressure ulcer prevalence rates. Nosocomial pressure ulcer prevalence rates were highest in long-term acute care facilities with anatomical location of greatest number of pressure ulcers being sacrum, hells and buttocks. The surveys also revealed that majority of Stage IV pressure ulcers were related to patients with dark skin: N=447,930 (total number of patients in survey), n1=1024 (dark skinned patients), n2 = 164 (dark skinned patients with Stage IV pressure ulcers). The incidence rates of pressure ulcers averaged at 5.4% which correlated with contributing factors of Braden Scores less than 18, serum albumin levels less than 3, fecal/urine incontinence, fragile skin and

Pressure ulcers remain a major health problem for many years. However, pressure ulcers have received minimal attention when we talk about patient safety issues. It is no doubt a patient safety issue as it can lead to serious damage such as life-threatening infections (Robyn). On a med/surge unit, individuals may experience long or short hospital stays depending on the situation. For the short stays, the focus of care is often on maximizing regaining activities of daily living and assessment and education regarding pressure ulcers is often minimal or non-existent (RNAO). What we fail to realize is that every patient who is at risk needs to be assessed and educated regarding pressure ulcers and the harm it can cause. During the hospital stay, patients may have limited movement and the pressure ulcers can extend into the muscle, tendon, and bone (RNAO). In many cases, patients do not notice the formation of an ulcer and as it may be in areas that are not as visible such as the coccyx. On a unit where there is short staffing, it is more vital to remember to assess for pressure ulcers and prevent the formation of an ulcer. Often, patients are admitted with the presence of a stage one or two pressure ulcer, whether it was from home or long-term care. In that case, patient education need to take place and teachings should be reinforced regarding the prevention of new pressure ulcers forming. Clients should also receive education regarding how to prevent

Williams, 1992 states that pressure ulcer occurs where there is poor level of nursing care for a long term basis but it is also found with hospitals that offer severe care. We know that a sore healing needs conditions of dietary aspects and it can be reversed. There have been several studies made

Each articles made the purpose of the article clear and emphases on the pressure ulcer risk factors and importance of prevention and management. Pressure ulcers once were considered an accepted evil that accompanied any prolonged hospital stay. Despite pressure ulcers being recognized as a largely preventable adverse event, they remain a major problem for patients in all health care settings and can lead to increased morbidity particularly for the chronically ill and the elderly. In some instances, pressure ulcers are complicated by infection, patient deterioration and even death if strategies are not implemented early in patients identified at risk. Performance improvement data can serve as a rich medium for the creation, development, and

Pressure ulcer prevention program is an interdisciplinary quality improvement initiative. It is designed to assist nursing home