Preview

Pressure Ulcers

Better Essays
Open Document
Open Document
4242 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Pressure Ulcers
Feature

Strategies to improve the prevention of pressure ulcers
Judy Elliott describes a project that sought to improve tissue viability during the patient journey from admission to discharge
Summary
This article outlines the actions taken by one acute trust to implement evidence-based, best practice recommendations for pressure ulcer prevention. Initially, an exploratory study identified specific areas for practice development, particularly improving early risk assessment, intervention and focus on heel ulcers. Further actions included recruiting tissue viability support workers to promote a pressure ulcer campaign. Prevalence audit results demonstrated improved prevention and reduced prevalence of hospital-acquired pressure ulcers by 6 per cent and heel ulcers by 4.9 per cent. Further work is required to ensure prevention strategies are consistent and documented.
Keywords Best practice, evidence base, pressure ulcer prevention (

Institute for Innovation and Improvement 2009), therefore it is important to seek further initiatives to eliminate avoidable pressure ulcers from NHS care.

Tissue damage
A pressure ulcer is defined as (European Pressure Ulcer Advisory Panel (EPUAP) and National Pressure Ulcer Advisory Panel (NPUAP) 2009): '...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.' Healthy individuals are continuously moving and readjusting their body posture to prevent excess pressure and shear forces. Reduced mobility or sensation interrupts this natural response, rendering an individual vulnerable to tissue damage. Eurther susceptibility is influenced by an individual's intrinsic risk factors reflected by their tissue tolerance (Bonomini 2003). Individual risk factors include immobility, malnourishment, cognitive impairment, acute and chronic ulness (National Institute for Health and CUnicad Excellence (NICE) 2005). Pressure ulcer prevention



References: Bcldon P (2007) Silting safely to prevent pressure damage. Wound Essentials. 2, 102-104. Bennett G, Dealey C, Posnetl J (2004) The cost oí pressure ulcers in the UK. A^e and Ageing. 33, 3, 230-235. Bonomini J (2003) Effective interventions for pressure ulcer prevention. Nursing Standard. 17. 32.4300. Bourdel-Marehasson I, Barateau M, Rondeau V el al (2000) A multicenter trial of the effects of oríü nutritional supplementation in critically ill older inpatients. Nutrition. 16, 1, 1-5. Calianno C (2007) Quality improvement strategies to prevent pressure ulcers. Nurse Practitioner. 32, 7, 10, 13-Í5. Catania K, Huang C, James P et al (2007) PlIPI 'l: The Pressure Ulcer Prevention Protocol Interventions. American Joumai of Nursing. 107, 4, 44-52. Clark M (2002) Pressure ulcers and quality of life. Nursing Standard 16. 22, 74-80. Clark M (2009) Guidelines for seating in pressure ulcer prevention and management. Nursing Times. 105, 16, 40-41. Clark M. Defloor T, Bours G (2004) A pilot study of the prevalence of pressure ulcers in European hospitals. In Clark M (Ed) Pressure Ulcers: Recent Advances in Tissue Viability. Quay Boolcs. London. Defloor T, De Bacquer D, Grypdonck M (2005) The effect of various combinations of turning and pres.sure reducing devices on the incidence of pressure ulcers. International Joumai of Nursing Studies. 42, 1, 37-46. Dobbs N, Spanbauer P, Datz D (2007) Continuous automated pressure ulcer monitoring. Journal for Nurses in Staff üe-elopment. 23. 3, 132-135. European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel (2009) I 're. '^sure Ulcer Prevention Quick Reference Guide. NPtJAP, Washington DC. Gebhardt K, Bliss M (1U94) Prevention of pressure sores in orthopaedic patients: is prolonged chair nursing detrimental? Journal of TLisue Viability. 4, 2, 51-54. Gould D, James T, I^rpey A et al (2000) Intervention studies to reduce the prevalence and incidence of pressure sores: a literature review. Joumai of Clinical Nursing. 9, 2,163-177. Hobbs B (2004) Reducing the incidence of pressure ulcers: implementation of a tum-team nursing program. Joumai of Gerontological Nursmg. 30, 11,46-51. Horn S, Buerbaus P, Bergstrom N et al (2005) RN staffing time and outcomes of long-stay nursing home residents: pressure ulcers and other adverse outcomes are less likely as RNs spend more time on direct patient care. American Joumai of Nursing. 105, 11, 58-70. Keogh A, Dealey C (2001) Profiling beds ver.sus standard hospital beds: effects on pressure ulcer incidence outcomes. Joumai of Wound Care. 10,2, 15-19. Moore Z, Price P (2004) Nurses ' attitudes, behaviours and perceived barriers towards pressure ulcer prevention. Joumai of Clinical Nursing. 13,8,942-951. NHS Institute for Innovation and Improvement (2009) High Impact Actions for Nursing and Midwifery. NHS Institute for Irmovation and Improvement, Coventry: National Institute for Health and Clinical Excellence (2003) The Prevention and Treatment of Pressure Ulcers. Clinical Guideline 29. NICE, London. Pancorbo-Hidalgo P, Garcia-Femandez F, Lopez-Medina I et al (2006) Risk assessment scales for pressure ulcer prevention: a systematic review. Journal of Advanced Nursing. 34, 1,94-110. Pbillips L, Buttery J (2009) Exploring pressure ulcer prevalence and preventadve care. Nursing Times. 105, 16, 34-36. Reddy M, Gill S, Rocbon P (2006) Preventing pressure ulcers: a systematic review. Journal of the American Medical Association. 296, 8, 974-984. Redelings M, Lee N, Sorvillo F (2003) Pressure ulcers: more lethal than we thought? Advances in Skin and Wound Care. 18. 7. 367-372. Robinson S, Mercer S (2007) Older adult care in the emergency department: identifying strategies that foster best practice. Joumai of Gerontological Nursing. 33, T, 40-47. Sewcbuk D, Padula C, Osborne E (2006) Prevention and eari> detection of pressure ulcers in patients undergoing cardiac surgery. AORN Joumai. 84. 1, 75-96. Tbeaker C, Kuper M, Soni N (2005) Pressure ulcer prevention in intensive care - a randomised control trial of two pressure-relieving devices, . ' aesthesia. 60, 4. 395-399. Vanderwee K, Grypdonck M, Defloor T (2007a) Non-blanchable erythema as an indicator for the need for pressure ulcer prevention: a randomized-controUed trial. Joumai of Clinical Nursing. 16. 2, 325-335. Vanderwee K, Clark M, Dealey C et al (2007b) Pressure ulcer prevalence in Europe: a pilot study. Joumai of Evaluation in Clinical Practice. 13, 2, 227-235. Walerlow J (1988) The Waterlow card for the prevention and management of pressure sores: towards a pocket policy. Care Science and Practice. 6, 1,8-12. Yin R (2003) Case Study Research, Design and Methods. Third edition. Sage Publications, Thousand Oaks CA. November 2010 Volume 22 I Number 9 NURSING OLDER PEOPLE Copyright of Nursing Older People is the property of RCN Publishing Company and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder 's express written permission. However, users may print, download, or email articles for individual use.

You May Also Find These Documents Helpful

  • Good Essays

    Nvq3 Unit 4222

    • 999 Words
    • 4 Pages

    5. Mobility has a significant role to play in the prevention of pressure ulcers. By facilitating the residents’…

    • 999 Words
    • 4 Pages
    Good Essays
  • Good Essays

    Pressure Area Care

    • 574 Words
    • 3 Pages

    Pressure sores or decubitus ulcers are the result of a constant deficiency of blood to the tissues over a bony area such as a heel which may have been in contact with a bed or a splint over an extended period of time. The surface of the skin can ulcerate which may become infected. Eventually deeper tissues are damaged. Besides the heel, other areas commonly involved are the skin over the buttocks, sacrum, ankles hips and other bony sites of the body.…

    • 574 Words
    • 3 Pages
    Good Essays
  • Better Essays

    For this unit you need to undertake risk assessment in relation to pressure area care and the risk of skin breakdown. This assessment will take place across a variety of health and social care settings, throughout hospitals, including operating departments, hospices, nursing and residential homes, day centres, and individuals' own homes. Risk assessment will include the use of different assessment tools selected for use to fit the individual and the environment. The assessment could be undertaken by a variety of staff within the varied care settings and is an ongoing process demanding constant review and evaluation. You will need to ensure that practice reflects up to date information and policies…

    • 1806 Words
    • 8 Pages
    Better Essays
  • Good Essays

    Ocf Course

    • 599 Words
    • 3 Pages

    Pressure ulcers tend to affect people with health conditions that make it difficult to move, especially those confined to lying in a bed or sitting for prolonged periods of time.…

    • 599 Words
    • 3 Pages
    Good Essays
  • Best Essays

    Ebt Task 1

    • 2000 Words
    • 8 Pages

    | |lower incidence of pressure ulcers. The problems were clearly identified and easy to understand. A structured |…

    • 2000 Words
    • 8 Pages
    Best Essays
  • Good Essays

    Pressure Area Care

    • 1008 Words
    • 5 Pages

    Some of the interventions that can be taken to help minimise the risk of pressure ulcers occurring in those that are at risk, one method is to that the individuals is position is changed on a regular basis, another is to use a pressure relieving device such as a special mattress, bed frame, seat…

    • 1008 Words
    • 5 Pages
    Good Essays
  • Satisfactory Essays

    Pressure Ulcers Stage 4

    • 148 Words
    • 1 Page

    Having pressure ulcers especially on stage 4 give impact to individual’s life. Impact may vary from person to person where some patient may feel having pressure ulcers is the worst thing can happen and some can live normally with the ulcers. First impact on having pressure ulcers is on quality of life. People who suffer from pressure ulcers experiencing excruciating pain while doing daily activities such as dressing changes.Individual who suffer from pressure ulcers also suffer from financial problem where they need to deal with expensive healthcare such as medical care charges, medication, trips for appointment and home modification. Next, patients may experience social isolation. Patients may feel isolated when they do the treatment. For…

    • 148 Words
    • 1 Page
    Satisfactory Essays
  • Good Essays

    The Oxford Dictionary defines the seven deadly sins as “the sins of pride, covetousness, lust, anger, gluttony, envy, and sloth.” Each of these sins are represented in Edgar Allen Poe’s short story The Masque of the Red Death. The seven deadly sins are related to The Masque of the Red Death through the seven rooms, and Prince Prospero’s character…

    • 272 Words
    • 2 Pages
    Good Essays
  • Powerful Essays

    National Pressure Ulcer Advisory Panel. Updated Staging System, 2007. Available at: http://www.npuap.org/pr2.htm. Accessed February 23, 2008.…

    • 1804 Words
    • 8 Pages
    Powerful Essays
  • Good Essays

    Knowing the prevalence, one could consider the actions leading up to the good and bad outcomes, compare the two to determine contributing factors, then put together a plan of action to prevent bad outcomes from occurring. The data collected on the unit could then be shared throughout the hospital to have better outcomes and a greater patient satisfaction score overall. Through this process, healthcare workers could learn to prevent nursing-sensitive indicator, such as pressure ulcers, by turning or repositioning patients at least every two hours. Being proactive throughout the hospital will reduce the number of hospital acquired pressure ulcers and help the healing process of those that were present upon admission. This also aids in a better patient satisfaction…

    • 740 Words
    • 3 Pages
    Good Essays
  • Powerful Essays

    For the purposes of this assignment, the patients name will be referred to as Mr S. Mr S was admitted from a care home onto our ward as a bed bound patient with a grade four sacral pressure sore which was severely bleeding and at high risk of infection. NHS Choices (2012) shows that this grading is the most severe type of pressure sore. The skin was severely damaged and the surrounding tissue beginning to die (tissue necrosis). The underlying muscles or bone may also be damaged. Pressure sores are a serious problem in health care systems. They cause pain and suffering and can lead to infection, and if not prevented or managed effectively can result in fatality. Nazarko (2005) Current research shows that Pressure sores are a common and often underrated health problem. Focus on disability (2012) estimates in the UK that between 4%-10% of all patients admitted to hospital will form at least one pressure sore. For elderly people with mobility problems, the figure can be as high as 70%. Pressure sores are an area of localized injury to the skin and underlying…

    • 1978 Words
    • 6 Pages
    Powerful Essays
  • Good Essays

    The NPUAP website has the ability to be a good start for clinicians in the battle of the bedsore. Sullivan & Schoells, (2013) further credit the information given by the NPUAP by stating, “guidance provided by such organizations as the Institute for Healthcare Improvement, National Pressure Ulcer Advisory Panel, and AHRQ has resulted in successful implementation of bundled evidence-based practices throughout the United States.” It is clear that the information on the NPUAP website is not only valid, but it is based on best practice and is evidence based. Nurses dealing with patients that are susceptible to pressure ulcers are doing themselves and their patients an injustice by not utilizing the tools that the site has to offer. Nurse educators, and wound nurses will find this site especially valuable and would be able to change practices and policies if needed based on the information the site provides. Another nice feature of the site (especially for the busy consumer researching medical information) is the link to Medline and the description it gives of the usefulness of evidence based…

    • 957 Words
    • 4 Pages
    Good Essays
  • Good Essays

    Pressure Ulcer

    • 568 Words
    • 3 Pages

    As part of your treatment plan, your care team will discuss with you the best way to prevent pressure ulcers. This will be based on your individual circumstances.…

    • 568 Words
    • 3 Pages
    Good Essays
  • Best Essays

    Pressure Ulcers

    • 1953 Words
    • 8 Pages

    This paper will discuss how pressure ulcers are essentially a serious problem within healthcare settings and how prevention is accountable in the development in pressure ulcers. The paper explores various ways to prevent pressure ulcers, reducing the risk factors, the responsibility of the duty of care of patients and the use of risk assessment tools. In order to prevent pressure ulcers, remove the risk. Evidence for this paper was gathered from seven peer reviewed journal articles from the online database CINAHL, a government website QLD Health and from various books.…

    • 1953 Words
    • 8 Pages
    Best Essays
  • Powerful Essays

    Reflection-Leg Ulcers

    • 2209 Words
    • 9 Pages

    de Laat, E.H. et al (2005) Pressure ulcers: diagnostics and interventions aimed at wound-related complaints: a review of the literature. Journal of Clinical Nursing; 14: 4, 464-472.…

    • 2209 Words
    • 9 Pages
    Powerful Essays