Pressure Ulcer Prevention and Management Discussion Paper
Pressure Ulcer Prevention and Management Discussion Paper
Introduction
The prevention of pressure ulcers is a challenge that must address by health care professional. Evidence-based practices should guide and support protocols in accomplishing objectives. This requires a coordinated strategy that will be effective in promoting patient safety for the patients who are at risk, advancing a prevention strategy that involves evidence-based protocols for improvement and skin preservation, and improving a patient’s physiological and psychological profile with the chosen protocol in place. The purpose of this discussion is to address the risks associated with pressure ulcers and how to promote prevention of these ulcers in hospitals and in long-term care facilities, using techniques proven through evidence-based practice as a guide.
Patient population
Older adults and other patients who are confined to a bed for lengthy periods due to disease or illness may face a greater risk of developing pressure ulcers, particularly if they are immobile. Pressure Ulcer Prevention and Management Discussion Paper Therefore, the risk of skin breakdown is much higher and requires nurses to develop and implement protocols on a regular basis that will be effective in meeting the needs of this patient population. Evidence-based approaches to addressing the needs of these patients are critical in expanding preventive efforts and to minimize the damage that may be incurred by patients. When patients experience pressure ulcers, their health is further compromised beyond its current state, which may be detrimental for their overall wellbeing and quality of life. Therefore, nursing-based protocols must be grounded in prior evidence in order to demonstrate a successful set of methods to prevent pressure ulcer formation in at risk patients, such as mattresses to reduce pressure and repositioning in order to prevent ulcer formation (Sving, Idvall, Hogberg, & Gunningberg, 2014).
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Diversity of the human condition
Patients who are at risk for pressure ulcer formation often lack control over their own care; therefore, they are unable to make decisions that may result in reduced risk and prevention (Black, 2015). There must be a greater emphasis on developing a strategy to accommodate patient needs and to prevent pressure ulcers that supports optimal protection of the skin over time (Black, 2015). The concept of risk assessment has been proven to be critical in this process yet less effective than other strategies, advanced static mattresses are an improved approach, while alternating-air mattresses have been proven to be an even more effective strategy that is likely to benefit these patients (Qaseem, Mir, Starkey, & Denberg, 2015). Therefore, different options are available to support pressure ulcer prevention, while also considering the impact of these tools in executing strategies at the nursing level to improve quality of care.
Influence of cultural values
The influence of cultural values on pressure sore emergence in heath care settings relates to the condition being associated with long term care especially, patients who are bedridden. Among them are those suffering from stroke episodes, cervical fractures, unconsciousness and others who have had surgical procedures that would cause them to be in bed for extended periods. The health care value linked to pressure sore is that no patient should develop a pressure sore during hospitalization. It is a clear indication of faulty nursing care. Pressure Ulcer Prevention and Management Discussion PaperWhen nurses are trained and heath care institutions are offering long term care the expectation is that persons working in these institutions and those managing patient care give full attention be give the best possible care. Culturally, no one expects to have any hospital acquired condition. The personal health care costs escalate along with that of the system. If Medicare or Medicaid is responsible for payments they have more costs to cover ( )
From a personal culture perspective pressure sores carry an unfavorable omen on a person’s recovery prognosis. It is believed that they take long to heal if they do and precedes death. Therefore, avoiding pressure sores in institutional settings is essential to patient satisfaction. Besides, while admitting the difficulty in mamaging pressure sores in hospital settings some cultures believe in their medicine man intervention in curing the condition .
Ethical considerations
Ethically, it is wrong to have patient in a facility with pressure sores. The national pressure ulcer advisory panel (NPUAP) has made sanctions regarding the prevention of pressure ulcer in facilities across America. A world wide pressure ulcer prevention day was identified in an effort recognize the impact of pressure ulcers and reduce incidences across the world. It was first celebrated on November 19th, 2015. Importantly the cost of pressure care amounts to 11 billion dollars annually and between $500 to $70,000 individually. There are distict clinical practice guidelines regarding prevention of pressure ulcers. If they were followed carefully there would notbe such alarming numbers in clinical care practice to the extent of it increasing (Hasler, 2014)
Proposed Solutions
Evidence-based research is aimed at preventing pressure ulcers rather than treating them since depending on where it occurs it is most difficult to cure. Prevention strategies include proper nutrition. Many bed ridden patients often do not eat. In heath casre settings where the patient to nurse ratio is low this specialized care is lacking. Trays are just left at patients’ bed sides and no one seems to care whether they eat or not. Therefore, healthcare organizations must ensure that there is enough staff to see that patients eat. While nutritious meals are prepared by agencies it is of no use to patients meal trays are left to the bed sides and removed just as full as they were placed there. Patients who cannot ear orally must be given alternative feeding methods to ensure adequate nutrition such as nasogastric tubes or intravenous feedings (Hasler 2014).
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Another neglected practice, which needs re-enforcement, is the use of pressure devices in vulnerable parts of the body to prevent development of pressure ulcers. Institutions must mandate their usage and make sure patients ‘pressure areas are treated every four hours. It is clear that these preventative measures are not currently been practiced in heathcare institutions where pressure sores are dominant
Concussion
The use of evidence-based data represents an opportunity to explore different dimensions of care and treatment that impact patients, thereby creating an environment in which patient care outcomes are likely to occur at a high level. Nonetheless, the appropriate evidence must be considered in order to address the problem of pressure ulcers, using the tools and resources that have been established in prior evidence in this regard.
Nurses might benefit from considering a combination of early risk assessment upon admission to the hospital or long-term care facility, accompanied by the use of alternating air mattresses and expanding patient mobility to prevent pressure ulcer formation and an increased risk of skin breakdown. This process reflects a need to explore the options that are available for patients when the risks associated with pressure ulcer formation are very high. It is believed that these tools will be employed in a manner that will be consistent in treating patients at risk for pressure ulcers and providing them with the tools and resources that are required to improve their health and wellbeing without having to address these risks.
References
Black, J. (2015). Pressure Ulcer Prevention and Management: A Dire Need for Good Science. Annals of internal medicine, 162(5), 387-388.
Hasler, E. (2014) National Pressure Ulcer Advisory Panel (2014), European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. Cambridge Media
Qaseem, A., Mir, T. P., Starkey, M., & Denberg, T. D. (2015). Risk assessment and prevention of pressure ulcers: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 162(5), 359-369.
Sving, E., Idvall, E., Högberg, H., & Gunningberg, L. (2014). Factors contributing to evidence-based pressure ulcer prevention. A cross-sectional study. International journal of nursing studies, 51(5), 717-725.
