RN-BSN Capstone Proposal

The Attitudes and Barriers of Nurses towards Pressure Ulcers in Long Term Care Facilities that Hinders Prevention & Treatment
Takoya Walker
College of Costal Georgia

Introduction and Background
Pressure ulcers (PUs) have post a problem to healthcare for thousands of years. Since at least the 1980s, pressure ulcers have been considered a result of poor quality of care (Lyder & Ayello, 2012). In response to the Institute of Medicine’s landmark report To Err is Human: Building a Safer Health System, the National Quality Forum designated hospital-acquired Stage III or Stage IV PUs as “never events” (considered avoidable health care incidents) (Agency for Healthcare Research and Quality [AHRQ], 2012). Since 2008, the Centers for Medicare & Medicaid Services no longer reimburse providers for treatment of facility acquired Stage III or Stage IV PUs. Populations at risk for PU development include older adults, patients with dementia, and any person with conditions of immobility (Ratliff, Tomaselli, & The Guideline Task Force, 2010). Because an older adult is more likely than a younger person to have impaired mobility and co-morbid health conditions, elders are especially vulnerable for PU development. This is of particular concern given the large population of these individuals in our nursing home facilities. In 1992, the AHRQ developed early guidelines for preventing pressure ulcers. In general, prevention guidelines focus on reducing the amount and time of pressure and shear through pressure-redistribution surfaces and frequent repositioning while providing nutritional support when needed, and protecting the skin from dryness and moisture (NPUAP/ EPUAP, 2009). With clear guidelines available, why do some nurses provide adequate PU prevention while other nurses do not? Why are interventions not performed