The Risks and Prevention of 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.

Jaul, E. (2010). Assessment and management of pressure ulcers in the elderly: current strategies. Drugs & Aging, (4), 311.

Assessment of a patient is key in preventing a pressure ulcer from occurring as well as keeping a pressure ulcer from getting progressively worse. A history of the debilitated patient can often determine the cause and risks. Some risk factors include bed rest/immobility, incontinence, diabetes mellitus, inadequate nutrition/hydration, and altered mental status. (Ignatavicius, 2013) Nurses must meticulously assess a patient history to determine the severity of developing an ulcer. The Braden Scale is a widely used tool for predicting a patient’s risk for developing a pressure ulcer. It uses 6 categories that include sensory perception, moisture, activity, mobility, nutrition, and friction and shear and rates the risk of 1-4 for each category. A patient with a score of <11 is at severe risk, 12-14 puts a patient at moderate risk, and a score >14 is at low risk. (Ignatavicius, 2013) When physically assessing a patient, the nurse must inspect the entire

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 affects patients the older patients due to the problem of immobility. A pressure

This qualitative study by Gorecki, Nixon, Madill, Firth, and Brown (2012) was conducted to ascertain the health-related quality of life (HRQL) as an important and relevant outcome in patients suffering pressure ulceration and the various factors that affect it. Pressure ulcers (PUs) are areas of necrosis and ulceration where tissues are compressed between bony prominences and hard surfaces.

Pressure ulcer prevention requires a team effort, involving physicians, nurses (including wound, ostomy, and continence nurses), dietitians, and physical therapists. Studies have demonstrated that comprehensive pressure ulcer prevention programs can decrease incidence rates, although not to zero. For optimal effectiveness, pressure ulcer prevention must begin as soon as patients enter the

According The Joint Commission pressure ulcers continue to be a problem across all health care settings. Approximately three million adults in the United States are affected by pressure ulcers, and up to eleven billion dollars are spent annually on their treatment (Qaseem, 2015). One of the national patient safety goals which The Joint Commission established was to assess every patient for the risk of developing pressure ulcers and to take appropriate action to treat any identified risk. This patient assessment can be achieved by utilizing the assessment tool such as the Braden Scale (National Patient Safety Goals, 2015). The Braden Scale assesses six areas: sensory perception, moisture, activity, mobility, nutrition, and friction or shear.

In 2008, the Centers for Medicare and Medicaid Services (CMS) announced that they would not be paying for any additional cost incurred for hospital-acquired pressure ulcers (Cooper, 2013). Pressure ulcers continue to be problem for health care organizations, despite their aggressive move to eliminate them in the health care setting. Furthermore, the acute care units pressure ulcers occurrences continues to be one of the most underrated problem that has a major impact on patient outcomes as well as reimbursement of care. Acute care patients are at a higher risk for developing pressure ulcers than other patients within the hospital. Primarily due to the fact that patients are hemodynamically unstable, from the use of vasopressors, the use of life saving devices, population age and other health issues. Health care must continue to place emphasis on the prevention of pressure ulcers in order to reduce co-morbidities and ensuing costs. The aim of this paper is to discuss the cost of pressure ulcers, multiple risk factors associated with the development of pressure ulcers, to show one acute care unit’s current practices to decrease pressure ulcers, look at evidence-based interventions, then to propose a change in current practice to reduce the number of pressure ulcers.

20). Further, the presence of pressure ulcers places a burden on patients and their family (Grinspun, 2005, p.21). As recommended by Grinspun (2005), pillows and foam wedges to separate prominences of the body and lifting devices have been beneficial to avoid friction (p. 32). Research suggests that the majority of pressure ulcers can be avoided. Although, the population at risk likely suffers from the possible contributors, as stated repositioning at least every 2 hours or sooner was effective (Grinspun, 2005, p. 32). When practicing I will reposition patients at appropriate times to reduce the risk of damage to the skin. Additionally, when moving a patient up in bed, I will request adequate assistance from other nursing staff to use a lifting device. This will help to avoid friction while the patient is being moved, ultimately reducing the development of pressure

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.

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

“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

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

It is clear that effective pressure ulcer prevention and treatment in paediatric patients are mandatory, taking into account their unique needs. This study revealed a very high pressure ulcer prevalence rate of 26.5%. However, an adapted, reliable, and valid PU risk assessment tool for a wide range of the population from neonates to adolescents has not yet been created. Therefore health care staff has to be aware of paediatric specific risk factors for pressure ulcer development, for example, the application of external devices, patients limited activity and mobility and decreased skin