...Abstract: In this assignment, I will discuss how pressure ulcers are essentially a severe problem with in healthcare setting and how prevention is accountable in the development in pressure ulcers. I will also address several 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. We must remove the risk to prevent pressure ulcers. Methods used is researched and reviewed articles discussing the responsibility of the healthcare staff. Pressure Ulcer Sores Pressure ulcers also known as pressure sores bedsores and decubitus ulcers, are confined damaged to the skin and/or underlying tissue that usually occur over bony prominence because of pressure in combination with shear and/or friction. These sores affect 9% of patients admitted to hospital and 23% of those admitted to nursing homes. Early detection and treatment accelerates recovery and reduces complications....
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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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...Nursing Practice: Pressure Ulcers Jane Smith Research and Scholarship for Evidence-Based Practice March 10, 2010 Evidence-Based Nursing Practice: Pressure Ulcers The primary goals for conducting nursing research are to generate new knowledge to promote positive outcomes for patients, enhance quality and cost-effectiveness of care, improve the healthcare delivery system, and validate the credibility of the nursing profession through evidence-based practice (Schmidt & Brown, 2012). The purpose of this paper is to explore the practice-related problem of pressure ulcers and the importance of the problem in the nursing profession. Practice Setting Problem Pressure ulcers are a serious concern in caring for adults in all types of settings (Stotts & Gunningberg, 2007). I have personally observed and cared for numerous patients with debilitating, painful decubitus wounds to their bodies both in long-term care and acute care settings. I will never forget a patient that I took care of at a long-term care facility; even after pain medications she would plead that she would rather die than have me change her pressure ulcer dressing. It is heartbreaking to know that the majority of these pressure ulcers could have been prevented had the correct measures taken place. It is essential for all healthcare providers to examine and explore the evidence based guidelines and information regarding pressure ulcers. This is important...
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...an increasingly more important role in nursing practice. With the increased utilization of nursing research comes a need for a form of communication that classifies diagnosis, applies interventions, and expected patient outcomes. In order to unify nursing communication and support nursing practice, standardized terminology has been developed. This paper will introduce three forms of standardized terminologies in nursing which are the North American Nursing Diagnosis Association (NANDA), Nursing Outcome Classification (NOC), and Nursing Intervention Classification (NIC). The purpose of this paper is to define the three standardized terminologies, processes developed, and to provide and example of their useful application in patients at risk for or diagnosed with pressure ulcers. The NANDA was established with the goal of enhancing all aspects of nursing practice by refining and promoting terminology to accurately reflect the clinical judgment of nurses (Azzolin et al., 2013). The mission of NANDA if to facilitate the refinement, dissemination, and development, and utilization of nursing standard terminology (Peres et al., 2015). Their main focus is to utilize this communication to promote evidence based practice and care, thereby improving care for everyone. NANDA promotes their missions and goals by publishing the world leading evidence based nursing diagnosis, funding research, establishing a global nursing network, and integrating evidence based terminology (Peres et al....
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...Educational Preparation Paper Grand Canyon University: NRS 434 This paper will discuss the differences in competencies between nurses prepared at the associate-degree level versus the baccalaureate-degree level, by using research from different nursing organizations found online. Also identifying a patient care situation in which I will describe how nursing care or approaches to decision-making may differ based upon the educational preparation of the nurse. Differences in competencies between ADN versus BSN In conducting the research for this paper I was a little biased in my opinions of this topic and had to keep an open mind. I am an associate-degree level nurse, and have been for six years. I feel that my experience has taught me a lot about critical thinking, and helping patients improve their outcomes. I felt pressure in to completing my baccalaureate-degree level of education before I felt that I was ready to complete the education. I now have a better understanding into baccalaureate education as being the accepted minimum requirement for nurses. Much research has been done, relating to BSN versus ADN nurses and better patient outcomes. In Grand Canyon University College of Nursing Philosophy, it states “Baccalaureate nursing practice incorporates the roles of assessing, critical thinking, communicating, providing care, teaching, and leading.” I feel that no matter what education level one has after nursing programs that this is a baseline for nurses. It was hard...
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...Change Paper Nursing 427 By Jennefer Grady Table of Contents 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...
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...The Significance of Having a Multidisciplinary Team 3 Abstract The growing prevalence and hospital acquired pressure ulcers is an immediate concern. The major challenge is the A major challenge is the lack of knowledge and skills in wound identification, management, treatment and prevention. This, along with other factors, creates poor patient care and vast costs to the pertinent facilities. The solution is to have interprofessional collaboration. The utilization of current advanced practice nursing staff as a resource for floor nurses and other involved healthcare workers is a must. This would obtain certification in wound care and be responsible for the ongoing continued education for wound prevention, monitoring and maintenance. The staff will be educated and trained at quarterly intervals on wound identification, staging, prevention, maintenance and monitoring. Key words: wound care, evaluation, pressure ulcers, multidisciplinary, specialist, evidence The Significance of Having a Multidisciplinary Team 4 Problem Identified The Centers for Medicare & Medicaid Services (CMS) declared in October of 2008 that it will no longer provide reimbursement for hospital acquired pressure ulcers (HAPUs) because it is a preventable occurrence (CMS, 2014). Even though the percentages of occurrences have declined since then, HAPUs continue to cause financial strain on institutions (estimated $9.1- $11.6 billion dollars loss annually)...
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...instrument specifically designed to aid health care workers evaluate the dangers of pressure sores that a patient faces is called the Braden Scale. After assessment, the victim is categorized depending on six aspects: capability of physical activity, hydration and nutrition status, capacity to alter position, the ability to respond after sensing discomfort related to pressure, shearing or exposure of the skin to friction during locomotion, and skin exposure to moisture. If the overall score is lower it means the risk of pressure sore is higher (Changing Practice, Changing Lives: 10 Landmark Nursing Research Studies, n.d). Prior to this Change, Skin assessment was based on non- formalized risk assessment which varies with each clinical practice. 2. Discuss why the current nursing practice needs to be changed Using non-formalized risk assessment in Predicting pressure ulcer resulted in non-uniformity and personal clinical judgement which varies from one person to another. Using Clinical judgement is more effective where the staffs are experienced and their experience assist in appropriate predictability, but with novice staff, the use of clinical judgment is inappropriate. In a multisite trial, Braden scale was tested by clinics bringing together skilled nursing facilities, Veterans Administration or VA medical centers and hospitals providing tertiary care. Of those who took part, none had experienced pressure sores earlier. Nurses evaluated those who took part in the trial with the...
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...Electric Pants Research Paper Hannah Bradley Finger Lakes Health College of Nursing Electric Pants Research Paper Bedsores are a common injury among the elderly and individuals who have disabilities that make them mobility challenged. Bedsores also known as, “pressure ulcers” are most commonly found along the buttocks, heels, shoulder blades or the back of the head. This occurs when blood flow is cut off to the surrounding cells, causing the muscles to be starved of proper nutrients and oxygen. This forces the tissues to break down. Pressure ulcers are common among individuals who are immobilized and those who sit in the same position for hours at a time. Bedsores can be devastating but with new electronic advances they can be prevented. Traditional practices utilize repositioning of patients every couple hours in order to eliminate bedsores. Now there is an easier way. “Scientists have a developed underwear with built-in electrodes that deliver small electric shocks to combat bed sores in patients who are in a coma or who have injuries that have immobilized them.” (Jha, 2012). These electrodes mimic the effect of moving around and send fresh blood back into the area with every contraction....
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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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...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 her why I was seeking her advice on research material and guidance she was glad to help, and give me a multitude of...
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...Abstract: Aim: To search and critically review research literature, concerning management and technique of compression bandaging. Background: Compression bandaging is required for venous leg ulcers, which is due to damage and loss of skin above the ankle that is the result of a problem with the veins in the leg. Although leg ulcers are not a life-threatening condition, it can have considerable effects, not only on health, but also on the quality of life, self-esteem and healthcare cost. Method: Extended literature review, to extrapolate best available evidence, in order to address the focus question. Computerised and manual searches of previous literature were used; refining searches by means of constantly re-evaluating inclusion and exclusion criteria. Results: Eight (8) articles were decided upon, seven (7) of which were quantitative and one (1) which was qualitative in design. Two main themes emerged from these articles, that of management strategies for leg ulcers and technique of applying compression bandages. Recommendations: Episodes of venous ulceration can be reduced with management strategies, such as graduated compression therapy with comprehensive technique. However, without further education for nurses and patients towards compression therapy, venous ulceration will prolong and management strategies will fail. Conclusion: Knowledge of compression bandaging technique needs to be increased through further training/education. ...
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...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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...4000- Research and Scholarship for Evidence -Based Practice September 6, 2015 PRESSURE ULCERS An essential part of nursing care of hospitalized patients is skin integrity maintenance. As markers of the values or products of care most affected by the assessment and interventions delivered by nurses, the rate of PUs is being screened thoroughly now than ever before (Manning, 2015). Pressure ulcers (PUs) are preventable, but PU rates persist to increase disturbingly fast, according to an article by Gary and Hampton published in 2015, the incidence of PUs has increased in the US between 1995 and 2008. The purpose of this paper is to review the incidence of PUs and how to prevent its occurrence and nurses’ responsibility. Practice Setting Problem Pressure ulcer occurs when part of the skin and the tissues underneath are impaired as a result of being placed under enough pressure to impair blood supply. Immobility-related pressure ulcers are defined as localized areas of tissue damage that develops when soft tissue is compressed between a bony prominence and an external surface for a prolonged time. The most common sites were the sacrum, the heel, the ischium and the trochanter. Pressure is where the weight of the body squeezes the tissues between a bony prominence (such as heel, elbow, sacrum or ischials etc) and a hard surface (such as bed, chair or, in the case of heels, the floor). There are four critical factors contributing to the development of pressure ulcers: pressure;...
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...Intro: What are Pressure Ulcers? Cayuga Medical Center’s Initiative Ideally, in modern medicine patients with wounds are bought to treatment facilities and when they leave they are healthier than when they came in. However, one problem threatens to change this. Pressure Ulcers, which form because of skin pressure reducing blood flow to an area of the body, have a habit of forming in patients with a variety of long-term problems as they are cared for in hospitals and nursing homes. The result of this is that in addition to whatever other problems a patient may have, the ulcer causes the skin and the tissue beneath the skin to die, and if the dead tissue is not quickly removed it can cause additional problems and pain for the patient. There are several factors that put one at risk of pressure ulcers, and these conditions are often difficult or impossible to treat. A typical pressure ulcer patient: suffers from mobility problems, is an older adult, has a spine or brain injury or disease such as multiple sclerosis, has a disease or condition that affect ones mental status, has fragile skin, has urinary incontinence or bowel incontinence or does not get enough nutrition. As most of these conditions are symptoms of old age or mental illness, these people will always be at risk of pressure ulcers, meaning the pressure ulcer prevention is there best chance of living comfortably. Pressure Ulcers can be treated but they are painful and if untreated they can result in death. They are...
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