Risk Assessment and Pressure Area Care

The next stage is to implement the care package, ensuring all the care staffs involved are made aware of the individuals’ needs and preferences. After 6 weeks we would then review the care package, making any adjustments if required, and following that the care package would be reviewed again in 12 months. If for any reason there was a change to the individuals needs or situation then a review would be carried out at an earlier date in order to address the change.

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

1. describe the anatomy and physiology of the skin in relation to skin breakdown and the development of pressure sores

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,

By finding about a person’s preferences, life history and wishes then the care plan can be written to reflect this and the best care can be given. By knowing their life history may explain why they do things in certain ways. It also encourages discussion and leads to building relationships. They may like things done in a certain way to remind them of loved ones who are no longer here.

It is necessary to involve the individual in the plan of care and support. Encourage the individual to make choices. This includes their needs, their culture, their means of communication, their likes and dislikes, wishes and feelings, advance directives, beliefs and values, involvement of their family and other professionals. This should be considered and documented. Also, there must be evaluation in assessing effectiveness in the plan of care.

Whilst undertaking the initial assessment, I always make sure that the service user is present and make sure that I am talking to them as opposed to about them with a family member or friend that also may be present. If I am doing an assessment with the service user who has Dementia or Alzheimer’s then again, I ensure that I am asking them what they would like, how they would like the care to progress and what they want to achieve from having care works. If they are unable to answer then I will look to the family for guidance, but it is important to make the service involved in their own care planning and assessment process

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.

In order to facilitate understanding of process data and outcome data, this essay will focus on the context of hospital-acquired pressure injury (PI). PI, also referred to as decubitus ulcers, bed sores or pressure sores, is defined as soft-tissue ischaemic necrosis localised in an area caused by prolonged pressure higher than the capillary pressure with or without skin tear or breach, related to posture over a bony prominence. The aetiology of pressure ulcers include: (1) pressure – weight of the skin against contact area; (2) shearing; (3) friction; (4) moisture; (5) position of the patient; (6)immobility; (7) neurological factors; (7) metabolic and nutritional factors; (9) oedema; and (10) age. PIs affects not only in infirmed older people,

The skin is the largest organ of the body and it acts as a waterproof protector for all of the internal organs, it is comprised of several layers including the Epidermis which is the outer layer and is a protective multi-layered self renewing structure which varies in thickness depending on which part of the body it covers. Under this is the Dermis, this is a layer of connective tissue which provides the skins elasticity and strength, it also contains sensory nerve endings, blood and lymph vessels, sebaceous and sweat glands. Under this layer is the Subcutaneous fat layer, this layer separates the skin from the underlying bone and muscle with a rich blood supply it also serves as an insulator and energy store. Pressure ulcers develop

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

Repositioning is also an essential recommendation for the prevention and treatment of pressure ulcers. It is important to determine the repositioning frequency based on the patient’s “tissue tolerance, level of activity and mobility, general medical condition, overall treatment objectives, skin condition and comfort” (EPUAP, NPUAP, & PPPIA, 2014). Repositioning initiates pressure relief and pressure redistribution. When repositioning, “the patient should not be positioned on bony prominences with existing non-blanchable erythema” (EPUAP, NPUAP, & PPPIA, 2014).

They evaluate if the skin was at risk for developing pressure ulcers after the patient was repositioned routinely every 2 hours. Measurement of the pressure points were taken every 30 seconds continuously (Peterson et al., 2013). The study is relevant to my study as well because they use the same method as far as pressure mapping as Behrendt et al (2014) but they measured pressure points. Their study showed that patients are still at risk to develop pressure ulcers when repositioned every 2 hours, some area of the body did not relieve from pressure after repositioning. This means that even after the patient was repositioned to prevent or reduce the risk of pressure ulcer formation, there are substantial areas of skin that do not get relieved and remain at risk for pressure ulcers regardless of routine repositioning by experienced nurses (Peterson et al., 2013). The study was done to reduce pressure ulcers prevention by revealing that other areas of the skin were still at risk after repositioning the patient. Further studies would reveal inconsistencies in this study whether or not these “triple jeopardy” areas will into pressure ulcers, progress a pressure ulcer or occur at specific tissue location only, these can be tested by expending the testing time to 24 hours rather than 4 to 6 hours. Expansion of

One important aspect of nursing service is to safeguard and maintain the integrity of the patient's skin so-preserved and intact. Intervention in the patient's skin care will be one of the indicators of quality of nursing care provided. Damage to skin integrity can stem from injury due to trauma or surgery, but can also be caused due to the suppression of skin preformance long time which causes irritation and will develop into pressure sores or decubitus.