Pressure Care Articles

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.

A full assessment of the wound should be carried out prior to selection of dressings. Any allergies should also be noted. The wound should be traced, photographed and measured providing data for comparison throughout the treatment. Consent should be gained prior to photographing the wound and the patient should not be identifiable from the photograph (Benbow 2004). All information should be documented in patients’ records, using the wound assessment tool. The pressure sore was identified as grade two

Outcome 1 understand the anatomy and physiology of the skin in relation to pressure area care

Pressure ulcer develops as a result of the skin that is over bony prominence. The pressure impairs blood flow leading to tissue necrosis and ulceration. Pressure ulcer can develop in several areas of bony prominence of the body such as the sacrum, greater trochanter, ankles, shoulders, head and ischia. It can develop quickly and difficult to treat, it ranges from mild to skin redness to severe tissue damage, development of infection and damage to muscle. Older people are most at risk due to thin and fragile skin,

J to prevent hospital acquired pressure ulcers. Frequent turning, repositioning, meticulous skin care and assessment are appropriate steps that would be taken to prevent pressure ulcers.

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

Pressure ulcers are a serious health care problem and it is crucial to assess how patients acquire pressure areas after admission to the perioperative environment (Walton-Geer, 2009). In the operating room factors related to positioning, anaesthesia and the durations of surgeries along with individual patient related factors can all contribute to pressure ulcer development. This essay aims to review current standards of recommended practice regarding pressure ulcer prevention efforts for the surgical patient.

The Material Flow Committee (MFC) knew that there were many problems associated with this process and that they had to change. The people involved in this group were Sridhar Seshardi, who was the vice president of Process Excellence; Nick Gaich, who was the vice president for Materials Management; Candace Reed, who was the director of the Sterile Processing Department (SPD); and Joan Rickley, who was the director of the OR. The first step that was taken by this committee was a pilot project called the “Early Morning Instrument Prep.” This development would involve a neurosurgery nurse coming to the hospital in the early mornings to make sure that all supplies and instruments were where they would be required for neurosurgery. Another aspect of this project was to “Provide early data into possible sources of problems” (p. 5). Once the MFC had reviewed the data that came back from the “Early Morning Instrument Prep,” they decided the Hospital would greatly benefit from hiring an Implementation Specialist for Healthcare (ISH). The ISH is a firm that has a specialization in

Although the situation was quite challenging, it provided me with some useful experiences for the future practice. I understand that all institutions should have a policy for documenting the assessment of patients, including pressure ulcers (Morison 2001). I have come to be familiar with the homes assessment policy using the Sterling Pressure Sore Severity Scale and most importantly I have learned that by using a universal assessment tool it supports a systemic and consistent approach to pressure ulcer evaluation. This therefore supporting continuity of care.

Today in clinical I experienced how to properly position a patient to prevent the risk of further damage, such as pressure ulcers.

Nurses need to realise what they are looking for when performing skin assessments for patients. A study conducted by Thoroddsen et al (2013), found that out of 45 patients that had pressure ulcers only 27 were correctly recorded in the patient’s records.

That being stated, if a patient must be placed on restraints, qualified professionals must have a comprehensive understanding of patient outcomes that correspond with the use of restraints. First and foremost, skin integrity is placed at risk if proper placement and management of patient care while in restraints is not implemented as with the case of Mr. J. There is numerous evidence based research studies conducted that correlate the use of restrains with an increase in pressure ulcers (Baumgarten, Margolis, Localio, Kagan, Lowe, Kinosian, Abbuhi & Abbuhi, 2010).

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

Thus, the expected outcome is that there is prevention of skin breakdown relating to pressure ulcers during hospitalizations for patients.

The head to toe physical assessment is to be performed in less than 10 minutes using a stethescope, pen light, your hands, and observational skills. It comprises of four different techniques: IPPA inspection, palpation, percussion, and auscultation. This sequence, in apparent order, is used for al systems except for the abdominal assessment, which requires auscultation before palpation and percussion. Inspection is visually examining the person, focusing on one area of the body at a time. Palpation is using touch, feeling for texture, size, consistency, and location of body parts. Auscultation is listening for sounds within the body, mainly listening the lungs, heart, as well as the abdomen with the use of a stethoscope. Percussion is tapping an area of the body with the fingers and is usually a special assessment skill that the RN or physician uses, not a practical student nurse.