Why Is Pressure Ulcer Important

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 are a problem and can lead to poor patient outcomes as well as hospital fines. Evidence based studies have shown that “the average cost of care in an acute care hospital for a patient with a stage III or stage IV pressure ulcer reported by the Centers for Medicare & Medicaid Services (CMS) is $43,180” (Jackson, 2008). Pressure ulcers and other skin breakdowns are among the most significant adverse events causing distress for patients and their care givers and compromising patients’ recovery from illness or injury (Gardiner, 2008). It is the tasks of nurses to ensure prevention of these complications is part of the daily care regimen.

“Pressure ulcers are key clinical indicators of the standard and effectiveness of care (Elliott, Fox & McKinley, 2008).” L.M. was at high risk for pressure ulcers for multiple factors such as immobility, poor nutrition, age, and health. Therefore, I used the Braden Scale as a quality indicator in order to assess the risk of pressure ulcers and also to

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 University Hospital is already on the brink of completely preventing pressure ulcers I would still recommend implementing all of the current practices but also add new additions to the team. Currently, we have a wound care team that diligently treats at risk and affected patients. Adding a nutritionist into the team to guarantee treatment from within along with prescribed medications. This will make the team and the strategies multidisciplinary. In addition to that, each treatment should be customized for each patient in regards to cost options and best treatment for their health. The project would also have to be performed repetitively without error to ensure that it is actually helpful. Patients’ skin should continue to be examined thoroughly in common places where ulcers could arise, the standardized pressure ulcer risk assessment should be used, and the proper care should be distributed once evaluated. The team should continue to record its progress and also provide company update emails to inform the facility, as well as send the appropriate data to the higher ups for public posting.

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).

Pressure ulcers are areas of localised damage to the skin and underlying tissue caused by pressure. (Stechmiller et al., 2008) Pressure ulcers still one of the most significant health problem in our hospitals today, It affects on patients quality of life patient self-image and how long they will stay in hospital then the cost of patient treatment . Moore (2005) estimate that it costs a quarter of a million euro’s per annum to manage pressure ulcers in hospital and community settings across Ireland .which allows one to take immediate actions and prevent the ulcer if possible. To support pressure ulcer risk assessment several standardized pressure ulcer risk assessment scales have been introduced

Pressure ulcers that occur in the long term care setting are increasing in the number of incidences each year in the United States. Consequences and complications of pressure ulcer development include pain, sepsis, cellulitis, bone, and joint infections. Pressure ulcers are also associated with an increased morbidity and mortality rate, negative emotional and physical effects on patients and caregivers, and are the second leading cause of litigation in long term care facilities. The cost of treatment for pressure ulcers in the United States is estimated at 11 billion dollars annually. This has led to many programs that focus on education and intervention to prevent the development of pressure ulcers, even being addressed in public initiatives such as Healthy People 2010. Appropriate information and education for healthcare providers, patients, and families has proven to be a key factor in the prevention of pressure ulcer development. Wound management is an area of healthcare that must include a comprehensive plan for the best outcome. A care plan that includes a well-educated care team composed of various disciplines working together for holistic care of each patient has seen the best results for patients who suffer from pressure ulcers.

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.

Pressure ulcer or bedsores as it is called is commonly referred to as very prevalent among high-risk patients, especially those confirm to hospital or long-term care setting. These individuals may be adults, elderly, frail, poorly nourished, and with comorbid illness. The objective of this assignment Is to Provide Awareness to my PICOT question which will be a quantitative research and will be supported by evidence-based research and obtained by systematic review from many database searches.

Pressure ulcers have a direct effect on patients and health care organizations. These effects will be discussed below, first looking

There is no policy or procedure in place to assess a patient’s risk for developing pressure ulcers. Nursing staff are alerted to areas of skin impairment, only by a patient or caregiver after an ulcer has developed. Once a pressure ulcer is discovered there is no standardized method of treatment to ensure appropriate wound healing. There is no standardized educational tool in place to inform a patient on the principles of pressure ulcer development and

Pressure ulcers are; damage to the skin or underlying structures from either inadequate perfusion or tissue compression. (Taber’s Cyclopedic Medical Dictionary, 2009, p. 1889). Those at an increased risk for pressure ulcer formation: older adults, persons with spinal cord injury, surgical patients, obese patients, underweight patients, children and patients at end of life. (Ruth & Nix, 2012, p. 125). The Braden Scale, is a tool used to help identify a patient’s risk of developing a pressure ulcer.

The National Pressure Ulcer Advisory Panel defines pressure ulcer as “localized injury to skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear.” Pressure ulcers are caused by unrelieved pressure usually located over bony prominences and are localized area of tissue injury. Agency of Healthcare Research & Quality has an effective vision regarding pressure ulcers: If you can’t measure it, you can’t improve it. To determine the severity of a pressure ulcer, an assessment of the lack of skin integrity is categorized according to severity by stages to reflect level of tissue injury or damage . Variations in the breakdown of skin are staged to correspond to the level of wound severity and the extent of tissue involvement which can range from mild reddening of skin to severe tissue damage to muscle and bones. Pressure ulcers can also result in severe infection.

Implementation stage consists of: (1) tracking, (2) collaboration, (3) planning, and (4) management. It will take place during the second month. During this stage, skin condition record (Appendix A), multidisciplinary team checklist (Appendix C), and chain of communication guide (Appendix D) will be implemented. All clinicians involved during this stage must utilize these documents. This stage involves bedside nurse, nutritionist, physical therapist, wound care nurse, and an intensivist. Primary nurse will track pre-admitted and developing pressure ulcers in patients. Skin condition record will be used to assess and document description. Staff nurse will follow chain of communication protocol afterwards. Collaboration will take place once a pressure ulcer is