Nurse Intervention To Prevent Pressure Ulcer (synthesis Assignment)

Nurse Intervention To Prevent Pressure Ulcer
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NURSE INTERVENTION TO PREVENT PRESSURE ULCER
Abstract
Pressure ulcers have been reported to be the second deadly disease. Most of the patients stay long in hospitals and incur high cost of treatment and sometimes succumb to the disease. The condition affects skin, bones and cartilages. Pressure ulcers are categorized with acute pains from affected bones and wounds. The treatment calls for surgery for the removal of the damaged tissues which is done by different medical practitioners depending on the affected area. A number of researches have been done to permanently cure the disease which much affects the elderly and immobile persons. The cost of treatment is high and few of the cases are successful. Nurses have therefore come up with various prevention methods that can be used to prevent the prevalence of pressure ulcers such as the use of air fluidized therapy beds to postoperative cardiovascular patients. The prevention methods are cost effective compared to the treatment cost. Some prevention methods used by nurses can be practiced by persons with informal education such as turning the patient at every two or three hours.
Clinical problem
Pressure ulcers can affect anyone regardless of age though commonly associated with the elderly or patients with other conditions such as long term spinal cord injury that make them immobile. The rate of survival is very low if the condition is at third stage and above. Nurses can intervene to control the condition
Purpose of the paper
The purpose of the paper is to provide alternative methods that nurses can use to prevent occurrence of pressure ulcers and reduce the effects of the disease in the already affected patients.
Search Engines: PubMed, CINAHL, PubMed, omniMedicasearch.com. ClinicalTrials.gov
Keywords Used: Pressure ulcers, nurses, bed sores
Results
Nurses intervention can help reduce pressure ulcers such as repositioning patients after three hours and improvise therapy beds.
Conclusion
The treatment process of pressure ulcers is long and expensive. Risk assessment scales for pressure ulcers can therefore be used by nurses to prevent its spread and impact. Air fluidized reduces the risk of postoperative cardiovascular patients to develop pressure ulcers. Though the cost of the beds is high, from the research it is evident that the treatment process of pressure ulcers is higher. The repositioning method where a patient is tilted 30 degrees is easy and cost effective.
Introduction
Pressure ulcers, also called bed sores or decubitus ulcers are skin wounds which may be caused by temperature humidity, continence, aging, medication or unrelieved pressure. Pressure ulcers can affect any part of the body including bones or cartilages such as knees, elbows, ankles and sacrum. Between 1992 and 2006, patients with pressure ulcers increased with nearly 80%. Most of them developed the condition after admission to hospital (NHS, 2005). According to the report by United Kingdom and United States authorities, pressure ulcers are the second major iatrogenic cause of death after drug reactions. Nurse in Britain used a research in 1950’s to exhibit the finest treatment and prevention of pressure ulcers by turning the patient after every two hours. According to United Kingdom’s National Health Service, between 4% and 10% of all hospitalized patients, at least one of the patient develop pressure ulcers while 70% of aged people in UK with mobility problems develop pressure ulcers (NHS, 2005). The people at high risk of contracting bed sores are immobilized people who might be as a result of illness and people with long-term spinal code injuries. Treating pressure ulcers requires a number of specialists such as dietician, neurosurgeons physical therapist and orthopedic surgeons among others depending on the part of the body affected. Sometimes the treatment procedure is risky because of the removal of damaged skin and tissues. Medical experts say that it is hard to prevent and heal bed sores especially to vulnerable people such as those suffering from obesity. They therefore advocate for prevention methods to maintain the skin’s integrity. The aim of the literature is to answer the PICOT question on how nurses can intervene to prevent pressure ulcer.
BODY
Literature search
Search engines: CINAHL, PubMed, omniMedicasearch.com. ClinicalTrials.gov. MedNets
Key Terms: Pressure ulcers, Electronic Medical Records (EMR), intervention, prevention.
Study 1
Talsma A, Tschannen D, Guo Y, Kazem J. (2011) Evaluation of the Pressure Ulcer prevention clinical decision report for bedside nurses in acute care hospitals. 2(4):508-21. doi: 10.4338/ACI-2011-07-RA-0046. Print 2011.
Objective
This study has two objectives; first, determine whether broadcasting of an automated day by day report indicating the patient risk and his/her present status of pressure ulcers can help prevent the increase of pressure ulcers, secondly, determine whether the use of pressure ulcers daily report information increases the severity of pressure ulcers that results in sensitive care setting.
Method
A prior study with four control units was deliberated to establish the effect of pressure ulcers daily in the intensive care unit in a medical center. Some of the control units that were used were intensive care units which used the same electronic medical records and similar cases that have a high risk of developing pressure ulcers. The study period began in March 2009 and ended on August 2009.
Results
The study involved 6,735 cases. The intervention unit reported a decrease (p=0.004) in pressure ulcers after evaluation with none of the four units showing decrease at p<0.05 level. There was a reduction of the total number of pressure ulcers documented showing p<0.00 and p=0.046 at stage II of the disease.
Strengths and weaknesses
This research was limited to specific intensity and magnitude of pressure ulcers. Thus, the findings cannot be used for all patients suffering from pressure ulcers. However, the research involved many cases (6735) of pressure ulcers patients which showed similar results. This makes the results reliable.
GAP
This research was successful based on the first objective according to the projections because the use of automated day report showed decrease the patients risk to pressure ulcers. The second projection however, differed from the expectations of the research because the use pressure ulcers daily report information showed a reduction of the severity of pressure ulcers.
Study 2
Cara Kelly (2010) “A new look at the Braden scale for pressure ulcer risk among older adults in home health care” Journal of BSN Honors Research 1(1) 2010
Objective
The objective of study is to use Braden scale to identify hospitalized and home nursing patients who are a high risk for pressure ulcers.
Method
Ten nurses volunteered to use Braden Scale to collect data of the study. An inter-rater dependability study was done to guarantee regularity in Braden Scale score and skin assessment amid the data collectors. After the nurses were through with the educational program, they completed the Braden scale and skin assessment tools for new patients who were admitted in the home care. The study was followed by another study that involving 5395 patient with over 60 years old and admitted in a home...