Evidence-Based Practice For Pressure Ulcers

Evidence suggests that pressure ulcers greatly increase mortality rates in both hospitals and nursing homes (Thomas, 2001). Patients who develop a pressure ulcer within six weeks of admission to an acute-care facility are three times more likely to die than patients who do not develop pressure ulcers (Thomas, 2001). Moreover, patients who develop a pressure ulcer within three months of admission to a long-term care facility are associated with a 92% mortality rate compared with a 4% mortality rate for patients who do not develop them (Thomas, 2001). This evidence alone shows how significant this problem is to the overall health status of patients. In my personal nursing experience, I have heard many complaints voiced from patients and their family members concerning the development of new pressure ulcers. Patients and family members have expressed dissatisfaction because of the increased stress and prolonged hospital stay often associated with the treatment 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.

The aim of this reflection is to describe my personal experience in wound care and its management. Gibbs (1988) reflective cycle has been adapted in order to provide structure to the reflection process.

Pressure ulcers continue to be a prevalent issue in the health care system and causes “pain, slow recovery from morbid conditions, infection and death” (Kwong, Pang, Aboo, & Law, 2009, p. 2609). In the field of nursing turning and repositioning patients is a well-known nursing intervention to prevent development of pressure ulcers. However, many hospitals and facilities still neglect to apply this as a standard policy. This gives room for nurses and nursing aides to overlook the importance of this intervention resulting in increased pressure ulcer development. The purpose of turning and repositioning patients is to prevent oxygen

A study conducted over seven years by Amir et al (2011) showed a significant decline of pressure ulcer development after three years of the study. This was partly due to strategies being implemented in regards to repositioning along with adequate nutrition, pressure ulcer prevention information leaflets were given to patients and skin assessments (Amir et al., 2011). It must also be considered that different patients will have different comorbidities and the use of a risk assessment tool is vital to assess and implementing a plan for pressure ulcer prevention according to the patient’s score (Tannen et al., 2010).

An interdisciplinary team of professional staff is a necessity to overcome the issue of pressure ulcer development among patients. Relevant stakeholders would include a nurse, nurse aide, dietitian, and a hospitalist. The primary responsibilities of the nurse consist of completing and documenting skin and risk assessments, monitor progress and/or changes in medical/skin conditions, report patient problems to the hospitalist, and work with the wound team

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

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

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).

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

According to Stockhausen & Conrick (2002), “Learning how to critique research articles is one of the fundamental skills of scholarship in any discipline” (p. 38). Burns & Grove (2011) found “An intellectual critical appraisal of a study involves a careful, complete examination of that study to judge its strengths, weaknesses, meaning, credibility, and significance for practice” (p. 419). The extent, amount and nature of publications accessible today by different means implies it has become crucial to prepare students and practitioners to judge the trustworthiness and helpfulness of published research (Stockhausen & Conrick, 2002, p. 38). The purpose of this report is critiquing a qualitative research article on pressure ulcers.

The presence of a pressure ulcer constitutes a geriatric dilemma, the cause of which is multifactorial. Some of the problems leading up to this condition are immobility, nutritional deficiency

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.

Older adults are vulnerable to pressure ulcer due to different factors. It is very common among older population especially in long term care facility. It is important for nurses to assess the client on a daily basis to prevent pressure ulcers from developing because once a pressure ulcer develops, it is very challenging to treat. (Kozier et.al., 2014 p. 1005).

In my workplace, we have recently implemented that if a patient is admitted from the ER or directly admitted from a physician’s office and they have any sensory impairment we must order them a “Stryker” overlay mattress. The stryker softcare overlay mattress is a single patient use mattress put in place in hope of preventing pressure ulcers. The mattress works by redistributing pressure to other areas by removing the constant pressure on pressure points along boney surfaces. This assist