Pressure Ulcer Safety Concerns in Healthcare

Pressure Ulcer Safety Concerns in Healthcare

Shayla L. Calvert

Moberly Area Community College 2016

Abstract

Pressure ulcers are of great concern in healthcare.  Due to these pressure ulcers a client can be exposed to longer hospital stays, increased healthcare costs, and loss of skin integrity.  If healthcare providers use the appropriate tools needed, prevention may be accomplished much easier.  Using a skin integrity scale and providing the clients that are at increased risk for a formation of a pressure ulcer with the best and proper devices to decrease the risk, is the key to prevention.  It is important for these providers to know and understand the risk factors and prevention techniques needed to keep a client’s skin intact and of good health.  With these tools used, the amount of pressure ulcers received in a hospital setting will decline, decreasing the healthcare costs, amount of hospital stays, and increasing the client’s health status.

Pressure Ulcer Safety Concerns in Healthcare

Pressure ulcers are of great concern in healthcare.  They cause increased costs, longer hospital stays, and loss of skin integrity.  A pressure ulcer is a localized injury to the skin and underlying tissue due to prolonged pressure of a combination of pressure with a shear or friction force in which they often occur over a bony prominence (Potter, 2013, p. 1177).  Patients are at increased risk for forming a pressure ulcer if they are experiencing problems such as decreased mobility, fecal or urinary incontinence, decreased sensory perception, and poor nutrition according to Potter (2013).

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When working in the healthcare field, you must be able to recognize the clients at higher risks for development of a pressure ulcer and manage their care based on their needs.  One assessment tool that may be used to recognize the risk for the development of a pressure ulcer is the Braden Scale.  According to Potter (2013) the Braden Scale is composed of six different subscales including sensory perception, moisture, activity, mobility, nutrition, and friction/shear.  With the use of this scale the client will have a rating from 6 to 23, with a lower score being a greater risk for the development of a pressure ulcer (Potter, 2013, p. 1184).  With the use of the scale you will be able to identify those clients at greater risk and provide prevention techniques to care for these clients.

There are many prevention techniques that are used in both the hospital and long term care settings.  Policies may differ from place to place on what they would suggest to prevent skin breakdown.  A few well know techniques that are used to prevent pressure sores include repositioning the patient, nutrition and vitamin support, support surfaces, and skin care needs (Badr, Mallah, Nassar 2014, p. 2).  According to Badr, Mallah, and Nassar (2014) one of the basic nursing care preventions include repositioning the bed ridden client every 2 hours to help eliminate interface pressure.  Positioning should be determined due the distribution of body weight.  The flatter that the client is positioned the more the body weight is evenly distributed (Elliot, 2015, p. 2).  According to Elliot (2015) when repositioning the client a 30 degree side-laying position or prone position is best advised.  Elliot (2015) also suggests that when a client is acutely ill and at risk for development of a pressure ulcer sitting in a chair should not be advised for over two hours at any one time.

Another prevention technique includes the use of vitamins and making sure client’s nutritional needs are met (Badr, Mallah, Nassar 2014, p. 2).  According to Badr, Mallah, and Nassar (2014) if these nutritional needs are met they will help to prevent and support the wound healing if a pressure ulcer occurs.  Other techniques include using support surfaces where clients will be spending their time.  Support surfaces such as foam mattresses have helped to demonstrate an improved performance in preventing pressure ulcers (Elliot, 2015, p. 2).  According to Elliot (2015) another type of mattress that helps to prevent pressure sores include mechanical support surface in which air is pumped throughout the mattress via alternating pressure.  Special sheets and overlays have also been designed that help to redistribute the pressure put throughout your body (Badr, Mallah, Nassar 2014, p. 2).

The last prevention technique that helps to contribute to prevention of skin breakdown is taking care of the skin.  According to Badr, Mallah, and Nassar (2014) excessive moisture or excessive dryness of the skin can exacerbate skin breakdown which makes the client more susceptible to a pressure ulcer.  Although some studies promote the use of barrier creams to prevent skin breakdowns the evidence to support this claim is weak (Badr, Mallah, Nassar 2014, p. 2).  Other studies on different products have been taken to find the best products to prevent skin breakdown.   According to Badr, Mallah, and Nassar (2014) many studies have concluded that the use of dressing such as hydocellular, hydrocolloid, or silicone foam dressings may help to reduce the incidence of pressure ulcers as a result of immobile ICU patients, and medical devices.

These prevention techniques above are used in the many different healthcare settings to prevent the formation of pressure ulcers.  These standard nursing practices used such as patient repositioning, vitamin and nutritional support, use of support systems, and skin care promotion can be used on many different types of client’s.  These aren’t specific to any certain age group, gender, race, and others.  If healthcare systems continue to practice these prevention techniques, the amount of healthcare associated pressure ulcers will drop and will lead to lower healthcare costs, and increased client satisfaction, safety, and health.

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References

Badr, L., Mallah, Z., Nassar, N. (2015). The Effectiveness of a Pressure Ulcer Intervention Program on the Prevalence of Hospital Acquired Pressure Ulcers: Controlled Before and After Study. Applied Nursing Research, 1-9

Elliott, J. (2015). Strategies to improve the prevention of pressure ulcers. Nursing Older People, 1-7

Potter, P., & Perry, A. (2013). Skin Integrity and Wound Care. In Fundamentals of Nursing (Eighth ed., p. 1177). Elsevier.