Essay On 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.

Nursing interventions play an important part in the reduction of pressure ulcers. A nurse can help to reduce the risk of pressure ulcers by promoting activity, carrying out skin inspections and assessments, and by using pressure relieving devices (Lynn, 2005). Some patients may fear being dropped when moved using equipment (Rogers, 1999), thus it is important for the Nurse to communicate with the patient, this way the Nurse can explain how the equipment works and the patient can express any concerns that they may have. It is important to remember that not all patients like lifting equipment and

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

education for the staff on what signs to look for concerning pressure ulcers as well as education on the laws and

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).

The main priority of the Veterans Affairs system is getting zero pressure ulcers. To achieve this goal, staff must be knowledgeable of the basic principles of skin disease, preventions, and treatments when providing care for the elderly patients. They provide education and training on the current evidenced-base practice on pressure ulcer preventions. The approach that has been effectively used is the care bundle (AHRQ, 2014). We

Despite advancement of technology, pressure ulcer continues to be a primordial in the health care system. Prevention of pressure ulcer remains an important issue in the health care facility. The critically ill ICU patient is the main target of this disease. Prevention remains the key for this problem. Some facility have standard policy for the eradication of pressure ulcer However the question is will the sacrum pressure ulcer formation be reduced in adult critically ill clients

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.

According to the Agency for Healthcare Research and Quality (AHRQ), 2.5 million patients are affected by pressure ulcers and incur costs anywhere from $9.1 billion to $11.6 billion per year in the United States (AHRQ, 2014). As of October 1, 2008, the Centers for Medicare and Medicaid Services (CMS) will not reimburse hospitals for cases in which the pressure ulcer was acquired after admission (CMS, 2008). Because of this high cost, the number of patients affected each year, and insurances no longer reimbursing hospital acquired pressure ulcers (HAPU), an accurate skin assessment upon admission is critical to reduce costs, ease pain in patients, and lower incidences of pressure ulcers. This paper will address what leadership and management skills and functions are required of a wound care nurse who identifies a problem with the accuracy of skin assessments on newly admitted patients.

The INTACT trial showed a significant reduction in pressure ulcers (PU) incidence in the intervention group at the hospital (cluster) level, but this difference was not significant at the

As we know pressure ulcers remain a tremendous problem in hospitals . it is distressing event for patient which affect quality of patients life and debilitating problem in health care. It cause suffering for patients and connected with high healthcare cost due to prolonged hospital stay and nursing care. Pressure ulcer are recognized as a patient safety problem and is a quality indicator of nursing care.

Nursing care is always evolving as new discoveries are made, so recurring nursing education is essential in providing modern, up-to-date care. Studies suggest that improved identification of pressure ulcers decreases the risk of HAPUs (Bergquist-Beringer et al., 2009). In 2006, the National Database of Nursing Quality Indicators (NDNQI) developed a pressure ulcer training program to help nurses identify and accurately stage pressure ulcers and accurately collect data for NDNQI pressure ulcer surveys. This program includes four modules. Module I, titled “Pressure Ulcers and Staging,” explains each stage of pressure ulcers and common pressure ulcer locations. Module II, titled “Other Wound Types and Skin Injuries,” covers different types of wounds and skin injuries that are commonly misclassified as pressure ulcers. Module III, titled “Prevalence Study Protocol,” covers accurate data collection, suggested pressure ulcer training, and pressure ulcer risk assessment and prevention. Module IV, titled “Community vs. Hospital/Unit-Acquired Pressure Ulcers,” covers the difference between community-acquired pressure ulcers and HAPUs. Five thousand two hundred individuals completed the NDNQI training program between November 2006 and April 2007 for continuing education credit. Those who left reviews most often commented on their positive learning experience and appreciated the use of multiple pictures of ulcers

Some of the problems we learned that could be encountered in reducing hospital acquired pressure ulcers is when dealing with patients who have diseases like diabetes mellitus, obesity, corticosteroids, coronary artery disease, renal disease. We learn that elderly people are the most prone to pressure ulcers because of their skin changes associated with aging, some of them have two or three chronic medical conditions at the same time; their decreased nutritional status, their mobility conditions, their ability to be aroused and respond to stimuli from their environment, tissue perfusion, frictional force and shear, and exposure to moisture (Plácido de Brito, Ferreira de Oliveira, Costa, Barros, & Dias, 2016). Also patients who are overweight and are immobile as a result can also be problematic in reducing HAPUs. Another problem we learned that can be encountered in trying to reduce hospital acquired pressure ulcers is inadequate staffing, lack of motivation, and not adequately educating the staff.

Pressure ulcers are localized skin and underlying tissue injuries due to constant pressure, shear or friction against another surface. Constant pressure and irritation blocks blood flow to the tissue and causes

Evidence based practice interventions to implement in the hospital thorough the high level of compliance to the guidelines. Compliance to interventions can improved by training, education, monitor the effect of the implementation, audit and feed- back (Logan et al., 1999). Through compliance to the bundle, the effectiveness of the bundle implementation can be measured. This will help to find the barriers that influence the compliance and increase the connection between the bundle implementation and research outcome. Monitoring compliance to the bundle will reflect the effectiveness of the implementation strategies used, obstacles to implementation and enable real time changes in implementation strategies to ensure effective intervention approval or compliance by clinicians. This study reports the findings which tested the effectiveness of a PU prevention bundle in improving skin integrity in the ICU (Tayyib et al., 2015b). The PU prevention bundle combined the latest international guidelines (available at the time of the study) for PU prevention (European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel, 2009) with PU prevention strategies related to medical devices (removed for blind review). The main components of the PU prevention bundle were risk assessment, skin assessment, skin