A pressure ulcer is localized damage to the skin and/or the underlying tissue that primarily occurs over a bony prominence, as a direct effect of pressure, or the pressure mixed with shearing and/or friction (National Pressure Ulcer Advisory Panel, 2007). Pressure ulcers are very painful, uncomfortable, and an expensive complication of being on bedrest. In most cases pressure ulcers can be averted through proper identification of patients who are at risk along with appropriate use of preventive measures. The frequency of hospital acquired pressure ulcers is a practical indicator of the quality of care given for inpatients (Perneger et al., 2000).
Pressure ulcers characterize a very severe problem for patients in the acute care setting, and a very indicative care management challenge for clinicians. Pressure ulcers primarily affect the elderly and patients that have impaired mobility. As this population of patients continue to age the incidence of pressure ulcers are likely to increase (Garza et al., 2006). The cost of treating a bedsore or pressure ulcer in a hospital setting averages right around $43,000 (WoundVision, 2011).
As nurses we are in the position to be the first line of defense for the prevention and management of hospital acquired pressure ulcers.
References:
Garza, S., Okere, V., Igbinoba, J., Novosad, K., & Pexton, C. (2006). Six sigma and change management: Reducing hospital-acquired pressure ulcers. Retrieved from http://www.gehealthcare.com/euen/services/docs/Reducing_Hospital_Acquired_Pressure_Ulcers.pdf
National Pressure Ulcer Advisory Panel (2007). Pressure ulcer stages revised by NPUAP. Retrieved from http://www.npuap.org/pr2htm
Perneger, T.V., heliot, C., Rae, A.C., Borst, F., & Gaspoz, J.M. (2000). Retrieved from http//:archinte.ama-assn.org/cgi/reprint/158/17/1940.pdf
WoundVision (2011). Pressure ulcer, wound care, and healthcare statistics. Retrieved from http://woundvision.com/statistics
Keesha,
ReplyDeleteThis is an awesome topic! Can you tell me a bit more about you and your expertise and experience in wound care?
Linda,
DeleteThanks for the inquiry. My nursing expertise is in medical surgical nursing. I have been nursig for nearly 13 years. Pressure ulcers is a topic I deal with almost on a daily basis in the acute care setting. I encounter alot of elderly nursing home and immobily impaired pateitns that present with different stages of pressure ulcers or they transfer from other units like ICU with pressure ulcer that have developed as a comlication of being on bed rest, decreased appitites, nourishment issues, incontinence, and other difficulties of healing such as diabetes mellitus. I hope that this helps you in understanding more about my expertise and wound care experiences.
Keesha
Preventing pressure ulcers is just a matter of good care. Using the Braden scale is helpful but I do not see it being used.
DeleteA patients skin assessment using the Braden scale should be done on admission and every tweleve hour shift (per facility) until the patient is discharged. It should be used regularly.
DeleteKeesha
A wonderful topic that has been a longstanding problem in the care of people who are immoble. We are required to assess the braden scale every 24 hrs on each patient. Great job!
ReplyDeleteI see this problem alot with the addmission of nursing home patients. The facility I am currently working requires a skin assessment on admission and then every shift thereafter until the patient is discharged.
DeleteKeesha
Keesha,
ReplyDeleteKeesha,
I've seen some horrible pressure sores. There seems to be a more vigilant policy for prevention now then there was a few years back. That is good because prevention is the key. Thank you for the info.
Mary B.
ReplyDeleteI think a lot of the vigilant policy for prevention has to do with Medicare and Medicaid not wanting to pay for patient extended stay in the acute care setting for hospital acquired pressure ulcer development. That has been a big issue in most staff meeting at the previous facility I worked.
Keesha