...Pressure Ulcers Donna Long Grand Canyon University NRS 433V Introduction to Nursing Research February 11, 2012 Shahin E. S. M., Dassen T., & Halfens R. J. G. (2009). Incidence, prevention and treatment of pressure ulcers in intensive care patients: A longitudinal study. International Journal of Nursing Studies 46: 413–421 Introduction Pressure ulcers refer to damage that occurs to the skin of a patient. Pressure, shear and friction are among the known causes (Shahin, Dassen & Halfens, 2009). Pressure ulcers mostly affect the lower part of the body, the elderly and patients with spinal injuries (Shahin et al, 2009). They are expensive to treat, require long periods of time and numerous treatments to heal. As a result, the cost incurred is very high and ranks among one of the most expensive ailments in the world to treat (Shahin et al, 2009). Background of the Study It is estimated that around 13% of patients in the ICU develop pressure ulcers (Shahin et al, 2009). “Pressure ulcers are the third most expensive disorder after cancer and cardiovascular diseases” (Shahin et al, 2009, p.414). This study looks into the prevalence of pressure ulcers in ICU patients, the factors related to it, and the treatment measures. Overcoming the problem of pressure ulcers is vital especially among critically ill patients who are at the most risk of developing pressure ulcers (Shahin et al, 2009). Educating nurses can reduce the occurrence of pressure ulcers...
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...JAN ORIGINAL RESEARCH Pressure ulcers and their treatment and effects on quality of life: hospital inpatient perspectives Karen Spilsbury1, Andrea Nelson2, Nicky Cullum3, Cynthia Iglesias4, Jane Nixon5 & Su Mason6 Accepted for publication 5 September 2006 Karen Spilsbury PhD RN Research Fellow Department of Health Sciences, University of York, York, England, UK Andrea Nelson PhD RN Reader School of Healthcare, University of Leeds, Leeds, England, UK Nicky Cullum PhD RN Professor Department of Health Sciences, University of York, York, England, UK Cynthia Iglesias PhD Research Fellow Department of Health Sciences, University of York, York, England, UK Jane Nixon PhD RN Deputy Head Clinical Trials Research Unit, University of Leeds, Leeds, England, UK Su Mason PhD RN Principal Research Fellow Clinical Trials Research Unit, University of Leeds, Leeds, England, UK Correspondence to Karen Spilsbury: e-mail: ks25@york.ac.uk 6 5 4 3 2 1 SPILSBURY K., NELSON A., CULLUM N., IGLESIAS C., NIXON J. & MASON S. ( 2 0 0 7 ) Pressure ulcers and their treatment and effects on quality of life: hospital inpatient perspectives. Journal of Advanced Nursing 57(5), 494–504 doi: 10.1111/j.1365-2648.2006.04140.x Abstract Title. Pressure ulcers and their treatment and effects on quality of life: hospital inpatient perspectives Aim. This paper reports a study exploring patients’ perceptions and experiences of the impact of a pressure ulcer and its treatment on their health and quality...
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...Pressure Ulcers: Wound Care Assignment Harman Unitek College Foundations of Nursing VNSG 100 Mr. Dhanda November 10, 2015 Pressure Ulcers: Wound Care Assignment Have you ever wondered what it looks and feels like if our skin gets torn up? You haven’t right? There are approximately 2.5 million who get pressure ulcers from hospitalization each year. From those 2.5 million patients, 60 thousand patients die from complications (Cooper & Gosnell, 2015, para. 4). In this essay, I will be explaining the normal causes, common treatment (tx), and prognosis for healing. Pressure Ulcers (PU) overall usually occur when there is sufficient pressure on the skin over bony prominences causing blood vessels in an area to collapse. Pressure ulcers result in ischemia or lack of oxygen and nutrients to the cells. PU usually take place over bony prominences such as: sacrum, scapula, elbows, heels, inner and outer knees, back of the head, and the hips. Since we are talk about stage III pressure ulcers, PU involves full thickness tissue loss where the subcutaneous fat is sometimes visible, but bones, tendons and muscles are not exposed. Stage III pressure ulcers vary depending on the location which also include: bridge of nose, ear, and the occiput. Deep stage 3 PUs develop in areas within layers of deep adipose tissue. The two main factors that play a role in development for pressure ulcers are shearing force & friction. Shearing force involves when the tissue layers of the skin...
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...Informative Article The informative article A United Approach to the Prevention of Pressure Ulcers informs the reader, step by step, as to what a pressure ulcer is, which patients may be prone towards a pressure ulcer, how to prevent a pressure ulcer, what to do if after steps taken towards prevention the patients gets a pressure ulcer anyway, treatment of an ulcer and finally what dressings are effective after treatment (Gray and Hampton, 2015). The key points of the article are that pressure ulcers (PUs) are preventable, but incidences of pressure ulcers continue to increase, patients with pressure ulcers die two to six times more than a patient without pressure ulcers, and pressure ulcers are preventable with proper care, such as utilizing the correct mattress and making sure turns are done faithfully. The article goes further and concludes that there are many methods that support pressure ulcer prevention and, with good training—knowledge of what a pressure ulcer is, how it occurs and how to prevent pressure ulcers there can be a reduction in pressure injuries overall. This article was subject to double blind peer review. Criteria Secondary source articles are usually based on articles that are primary sources, or in other words, research articles (which are primary) where the information can be new or groundbreaking. When an informative or secondary article is written the authors may use the...
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...Running head: SACRUM PRESSURE ULCER REDUCE WITH FOAM DRESSING Sacrum Pressure Ulcer Reduce With Strict Use of Foam Dressing Chamberlain School of Nursing Penni-Lynn Rolen NR 451 Capstone Course Sacrum Pressure Ulcer Reduce With Strict Use of Foam Dressing 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 in the ICU by implementation of strict use of foam dressing? Reviews of evidenced base article, and foam dressing trail will turn on the light. Contribution to the Future of Healthcare According to recent literature and research, pressure ulcer remains one of the problems confronted by hospitals and other health care facilities around the countries. Intensive care patients are the largest group of patients who end up with pressure ulcer during their stay in hospitals. Taking care of patients with pressure ulcer consume a large part of hospitals budget. Prevention of pressure ulcer is not only the job of bedside nurses, but also the responsibilities of nurse educators as well as administrators. Prevention of pressure ulcer will contribute to...
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...INTRODUCTION This essay is a critique based on a pilot study carried out on ‘patient stories of living with a pressure ulcer’ and I will be using Caldwell, K. et al. (2005) as a structured research framework to carryout the evaluation on this study. First and foremost a definition of what research, (nursing research in particular) and research critique entails will give a greater understanding of what this essay aims at addressing. On one hand, Polit and Beck (2006, p4), defined research as a systematic inquiry that uses disciplined methods to answer questions or solve problems, while on the other hand they define nursing research as a systematic inquiry designed to develop knowledge about issues of importance to nurses, including nursing practice, nursing education and nursing administration. The importance of having research carried out in the nursing field can only be emphasised as it is the key element in generating and guaranteeing evidence to guide nursing practice and improvements to care and quality of life of both clients and service users as claimed by Polit and Beck (2006, p4). However once the research is undertaken and published, great emphasis is placed in finding out or identifying the strengths and weaknesses through critique. Polgar and Thomas (2000), point out that critiquing research entails identifying the strengths and weaknesses of research publications to ensure that patients/clients receive assessments and treatment based on the best available evidence...
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...RESEARCH STUDY Quantitative Research Study Knowledge Pressure Ulcer Prevention among Nursing Professionals Jeamol Joseph Grand Canyon University NRS-433= Introduction to Nursing Research 24 July, 2011 Quantitative Research Study Nursing research is a process which helps to improve the patient outcomes through a thorough analysis of data collected and making new contributions to the healthcare field. Evidence based nursing is the process by which nurses make clinical decisions using the best available. In quantitative studies researchers identify the problem and collect relevant data from subjects. The researchers plan in advance the steps to be taken and collect data in numerical form. In qualitative studies, researchers collect narrative descriptions. Data is collected and progression takes place as the research is continuing. Nursing research is systematic search to develop evidence on problems of nursing profession. Now days hospitals deliver higher quality care to critical patients .In hospital settings these patients are more susceptible to hospital acquired infections and injuries. All the institutions have used effective strategies to avoid complications that keep their patient’s safety at risk. Quality improving programs and patient safety committees are available in all hospitals to promote patient safety. Pressure ulcer or bed sores are important problem in hospitals and nursing homes. Pressure ulcers prolong the hospital stay of hospital. They increase...
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...very important topic in modern medical field. Pressure ulcers are the major problem in the long term facilities. Having an understanding of the exact cause of pressure ulcers helps place the role of repositioning into context. Demographic and epidemiological data suggest that health-care demand will increase considerably in the future as a result of an ageing population and a rise in the prevalence of chronic diseases such as diabetes. This phenomenon has come to be referred to as the ‘health care time bomb’ in the popular press and political discourse. The authors seek to look beyond the headlines and political rhetoric to clarify the extent to which they reflect the likely future reality with a specific focus on wound management. The present-day burden that wounds and current wound management practices place upon the health-care system are detailed and clarified, and the potential future implications of increasing wound prevalence on the current picture are explored. Possible opportunities to enhance current wound management practice as identified in the analysis are discussed. Declaration of interest: Alistair Biel by is a contractor for Smith & Nephew. Richard Searle is and employee of Smith & Nephew. This project was supported by an unrestricted grant from Smith & Nephew. As such, a pressure ulcer is defined as localized injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure or pressure in combination with shear. A number of contributing...
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...A written assignment that evaluates comprehensive approaches to nursing assessment for an older person with multiple health problems. The account should reflect on how the multidisciplinary team and other agencies including the family, may contribute to these assessment approaches. Particular attention should be paid to national policies in this area and evidence of best practice. The patient that will be discussed within this assignment is a 70 year old male admitted to hospital following a stroke. Pressure ulcer risk assessments and nutritional risk assessments will be discussed within this assignment looking at how they are used in the assessment of an older people with multiple health problems. A stroke occurs when there has been a disturbance or cut off of blood flow within the brain, this disturbance damages or destroys brain cells preventing these cells from doing their job. Damage to the brain causes problems with bodily functions and can also affect mental processes (Stroke Association, 2010). A stroke can cause sudden weakness or paralysis which often only affects one side of the body and is one of the most common symptoms of a stroke. It can also cause swallowing difficulties (dysphagia), speech and language (dysphasia) can be affected also, patient may have difficulty in understanding and basic things such as reading and writing following stroke. Problems with eyesight, perception and interpretation, mental processes, bladder and bowels, mood swings, sensation and...
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...around interventions, outcomes, and costs.” (Hood, 2010) Prevention is the key to interventions, outcomes, and cost. People associate pressure ulcers with long term care. They can occur during a long surgery. As nurses we need to be sure that we are doing our part to prevent them no matter what the setting. If the patient has poor nutrion status or certain other qualifiers their chances for receiving a pressure ulcer increase significantly. With keeping this in mind we need to ensure that we do what we can to prevent pressure ulcers. Even in acute care pressure ulcers occur. They can happen in as little as an eight hour shift. With different health conditions making it easier for someone to acquire a pressure ulcer. The risk of acquiring one in acute care is a stagering “2.7 percent to 29.5 percent” (AHCPR Supported Clinical Practice Guidelines). As a nurse we have a responsibility to our patients to give them the best care available. With that we have to prevent harm from our clients. As nurses we need to be aware of what is happening to our patients. We have to know what is their acute health care problem and then prevent any more harm to them. “Guidelines suggest that our overall goal is prevention of pressure ulcers which is less costly.” (AHCPR Supported Clinical Practice Guidelines) If we prevent pressure ulcers from happening with an overlay mattress, and it will cost less in the overall...
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...Evidence Based Practice & Pressure Ulcers Matthew Slawter Chamberlain College of Nursing NR451 RN Capstone Course November 2014 Evidence Based Practice & Pressure Ulcers Evidence based practice (EBP) gives nurses a method to use critical appraised data and scientific evidence that is proven to confirm the delivery of quality health care to a patient population. Pressure ulcer prevention continues to be a major and growing concern among todays patients and healthcare providers. This problem is a concern because prevention of pressure ulcers can be accomplished through good skincare techniques and increased education of nurses. The field of nursing along with the healthcare industry can benefit from simply decreased the occurrence of pressure ulcers. The general purpose of this proposal is to determine if the value nurses place on skincare and pressure ulcer prevention can decrease the incidence pressure ulcers. Change Model Overview The John Hopkins Nursing Evidence-Based Practice Process is simply related to the complex challenges organizations and nurses face with the implementation of evidence-based practice and translation. Furthermore, this process provides guidelines for managing the process, structure, and evidence translation among various healthcare settings and outcomes of EBP projects. Nurses should use this process as a guide to facilitate change as it suggest leadership and planning for EBP measurement, identification, evaluation and monitoring...
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...to get up in a chair twice a day. Joan, a student nurse, is caring for Mr. Gordon this morning. She has reviewed his medical record and is now ready to start caring for him. 1. Joan assesses Mr. Gordon using the Braden Scale and determines that his score is 12. What does this score indicate about Mr. Gordon’s pressure ulcer risk? Explain what the Braden score is. * Mr. Gordon has a high risk of developing a pressure ulcer because his score is a 12 on the Branden Scale. The lower the score on the Branden Scale (6-23) the higher the risk of developing a pressure ulcer. The Branden Scale is used to determine any limitations with a patient’s sensory perception, activity, nutrition, moisture, and mobility. 2. Joan is assessing Mr. Gordon’s skin and notices that he has a 3 cm blister and a shallow crater on his buttock. Mr. Gordon winces when Joan palpates the area. How should Joan stage this area and Why? A. Stage I pressure ulcer B. Stage II pressure ulcer – A stage II pressure ulcer includes having blistering, shallow craters, and associated pain. C. Stage III pressure ulcer D. Stage IV pressure ulcer 3. Mr. Gordon has drainage coming from his surgical incision and his dressing needs to be changed. What...
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...achieved during the module, I could have chosen such accomplishments as VAC (Vacuum Assisted Closure) therapy, Maggot therapy or Nutrition and Dietetics. But I wanted to go back to basics and review and fully expand a skill that I knew of, which is Pressure Ulcers (also called pressure sores or bed sores). A stated by the NHS Choices website “It is estimated that in any given year fewer than half a million people in the UK will develop at least one pressure ulcer. About 1 in 20 people who are admitted to hospital with acute sudden illness will develop a pressure ulcer; this is usually people with underlying health conditions.” I have been a H.C.A (Health Care Assistant) for over 17 years to now, and I have always been aware of pressure ulcers, and how to try to avoid them but never really knew the complete details of What, How or When of them. I have been on many different courses for H.C.A’s through the years, but they have all really skimmed over the subject of pressure ulcers. I now work on a vascular ward of the hospital where many of the patients are bed or wheelchair bound due to lower limb amputations, caused by complication from diabetes mellitus to circulatory problems. So I thought that by widening my knowledge on pressure ulcers and skin viability, I can and will improve services to the patients I come into contact with. When trying to conduct my research for adequate literature I decided to contact the hospital Tissue Viability Nurses Specialist. When I explained to...
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...Introduction………………………………………………………………..3 Lewin’s Theory……………………………………………………………..4 Problem Statement………………………………………………………….5 Proposed Solution…………………………………………………………..6 Moving Forces………………………………………………………………7 Restraining Forces…………………………………………………………...8 Change Integration…………………………………………………………..8 Refreezing Process…………………………………………………………..9 Introduction On patients requiring bipap masks, what is the effect of applying duoderm to bridge of nose compared to not using any barrier to prevent skin breakdown while in the hospital? This paper is about a problem that has been identified in the nursing field and the change process. Patients who need to wear a bipap mask for better oxygenation are having complications with the mask causing a pressure ulcer on the bridge of the nose. This is not only painful to the patient but also increases health cost. This paper is about Lewin’s change theory and how to implement this new change and overcome resistance. It will talk about the freezing, moving and refreezing process, changes that need to be made and how to implement this plan. As well as what is necessary to enforce this change so that it becomes status quo. Lewin’s Theory Kurt Lewin was born in Germany and immigrated to the US in August of 1933, after Hitler came to power. He had originally been involved with schools of behavioral psychology before changing directions and going into research. He is well known for his writings on group dynamics, group therapy and social psychology...
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...Limitation Although evidence4,21-23 supports the total score on the Braden Scale as a predictor of pressure ulcers in critical care patients, investigation of the contributions of the subscale scores has been limited, and the findings have been inconclusive. Although the subscales of sensory perception,22,24 moisture,21,24 mobility, 21 and friction/shear24 have been found to be significant predictors of pressure ulcer development in ICU patients, the activity and nutrition subscales have not. Other factors not included in the Braden Scale may also increase a patient’s level of risk for pressure ulcers and thus be important determinants in adult critical care patients. Empirical evidence suggests that the following factors can be predictive of pressure ulcers in critical care patients: advanced age1,4,21,25,26; low arteriolar pressure27-29; prolonged ICU stay1,21,26,30; severity of illness as indicated by scores on the Acute Physiology and Chronic Health Evaluation (APACHE) II1,31; comorbid conditions, including diabetes mellitus, sepsis, and vascular disease21,25,27; and iatrogenic factors, such as the use of vasopressor agents.1,25,2 Shahin ES, Dassen T, Halfens RJ. Pressure ulcer prevalence in intensive care patients: a cross-sectional study. J Eval Clin Prac. 2008;14:563-568. One criticism of this tool is the inability of staff to distinguish what is meant by some of the parameters. An example of this is the use of risk factors, such as ‘mobility...
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