Prophylactic Sacral Dressing ( Icu ) And A Recommendation Proposal

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.

Treatment of a pressure ulcer costs the NHS more than £3.8 million, despite the progress and management of pressure ulcers 700,000 people are still affected this remains to be a significant problem for health care professionals (NHS Improvement, 2016). Therefore, this case study will enumerate the cause, treatment, prevention and risk factors of a pressure ulcer in relation to a patient who is suffering from a grade three-pressure ulcer to his sacrum and therefore requires long-term care from the district nurses. Pressure ulcers can occur more commonly on the sacrum or heels in any health care settings (Clarkson, 2007). Although more prevalent in the elderly, people of all ages are at risk of developing a pressure ulcer

I have significantly developed my skill in wound care assessment and dressing, in developing this skill I now recognize the importance of documenting each dressing. Morison (2001) supports this in saying that by detailing pressure ulcer assessment it provides a basis for deciding the effectiveness of the current treatment.

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

Most patients who end up in intensive care unit are most of the time so unstable that any little movement will put them at risk for further complications which can lead to death. However, finding a way to prevent pressure ulcer in the most critical ills patients in the healthcare system is very crucial.

Pressure ulcers occur over bony prominences when skin is compressed for long periods of time, affecting the blood supply to certain areas, leading to ischaemia development (Waugh and Grant, 2001). Compression of skin is caused by pressure, shearing and friction, but can also occur due to pressure exerted by medical equipment (Randle, Coffey and Bradbury, 2009). NICE (2014) states that the prevalence of pressure ulcers in different healthcare settings in December 2013 was 4.7%, taken from data available for 186,000 patients. The cost of treating ulcers can vary depending on severity from £43 up to £374 (NICE, 2014). Evidence based practice skills are essential in nursing as it allows the best available evidence to be used to improve practice and patient care, while improving decision-making (Holland and Rees, 2010). I will be critiquing two research papers; qualitative and quantitative, using a framework set out by Holland and Rees (2010), and will explore the impact on practice. Using a framework provides a standardised method of assessing quality and reduces subjectivity.

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.

Wolters Kluwer Health, I. (2017). Pressure ulcers get new terminology and staging definitions: Staff repor. Nursing Management,

It is important to count & track pressure ulcer rates as a major factor for quality improvement. Being able to track pressure ulcer rates, care can be altered to better improve medication interventions and ultimately decrease the rates of pressure ulcers. It also allows the interdisciplinary team members be able to gain perspective on data trends. Improvement efforts are ongoing basis and the AHRQ recommends that pressure ulcer incidence or prevalence rates be monitored to determine outcomes, utilization of at least one or two skin assessments, and determine responsibility for overseeing accuracy of skin assessments.

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

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,

One of the greatest indicators for the quality of care is health care facilities is the amount of pressure ulcers acquired in patients. Approximately 1 million people develop hospital-acquired pressure ulcers each year affecting hospitalized patients in both acute and long term care settings. The incidence of pressure ulcers ranges from 0.4%-12% in acute care settings, along with the prevalence range from 12%-18%. Pressure ulcers cause increase pain, suffering, and decreased quality of life along with extended hospital stay. According to the national pressure ulcer advisory panel a pressure ulcer is defined as “localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination

Pressure ulcers additionally called bedsores or pressure sores, are wounds to skin and fundamental tissue coming about because of delayed weight on the skin. A pressure ulcer is confined damage to the skin or basic tissue more often than not over a hard unmistakable quality, as a consequence of weight, or weight in blend with shear and contact. Since muscle and subcutaneous tissue are more defenseless to weight incited harm than skin, bedsores are regularly more awful than their introductory appearance. Pressure ulcers are then organized to direct clinical depiction of the profundity of detectable tissue demolition. It is assessed that these ulcers commonness in intense consideration is 15%, while frequency in intense consideration is 7%. It is evaluated that 2.5 million patients are treated for bedsores in US wellbeing acute care facilities every year. Pressure ulcers cause significant damage to patients, obstructing useful recuperation, often bringing on torment and the improvement of genuine diseases. They have additionally been connected with a broadened length of stay, sepsis, and mortality. Truth be told, about 60,000 US facility patients are assessed to pass away every year from complexities because of these ulcers. The evaluated expense of dealing with a solitary full thickness ulcer is as high as $70, 000, and the aggregate expense for treatment of pressure ulcers in the US is assessed at $11 billion every year.

Pressure ulcers remain an issue in nursing, as they cause financial losses to not only the patients, but also the healthcare sector. In addition, the expenses arising from extended hospital stays, an increase in readmissions, and admissions to the hospital are included as well. Over the years, preventive interventions have focused on the elimination of pressure ulcers. In such cases, the prevention strategies have concentrated on the role of nurses in preventing the occurrence of pressure ulcers. Current texts reveal strategies that can be implemented in order to effectively manage and prevent pressure ulcers in the healthcare sector. The use of a proficient wound care team is common in many skilled nursing facilities. The failure for the effective management of this ulcer demonstrates a need for the adoption of new beneficial strategies. While previous researchers have proposed investigations on the effectiveness of a wound care team in the management of a pressure ulcer patient, the gap between writings and implementation still persists. Nurses have a role in presenting a plan that will encourage effective prevention and management of

1259). One of the key component of the nursing history and physical examination is the assessment of the integumentary system for pre-existing conditions or the risk assessment for potential breakdown in skin integrity. Nurses are in the position to have an impact on the financial cost of pressure ulcers to both the health care system and the patient completing a thorough, daily skin assessment during hygiene care or independently for early recognition and early intervention (Potter& Perry, 2014, p.851). Another best practice is illustrated by with use the acronym, R.I.S.E which was devised to promote the basic principles of pressure ulcer prevention among carers. Reposition; regular repositioning can help prevent tissue damage. Inspect; daily inspection of the skin can identify areas that are at risk of ulceration. Skin care; washing and drying the skin can prevent tissue damage. Eat well; good nutrition and hydration are essential for health and wellbeing (Gethin &McIntosh, 2014, p.