Nursin Nursing Practice Paper

However, only 10% of nurses actually complete accurate inspections of the skin during their initial physical assessments of the patients (Lahmann et al., 2010). As a result, patients who are at risk of developing pressure ulcers are often overlooked by nursing staff.

A study conducted over seven years by Amir et al (2011) showed a significant decline of pressure ulcer development after three years of the study. This was partly due to strategies being implemented in regards to repositioning along with adequate nutrition, pressure ulcer prevention information leaflets were given to patients and skin assessments (Amir et al., 2011). It must also be considered that different patients will have different comorbidities and the use of a risk assessment tool is vital to assess and implementing a plan for pressure ulcer prevention according to the patient’s score (Tannen et al., 2010).

An interdisciplinary team of professional staff is a necessity to overcome the issue of pressure ulcer development among patients. Relevant stakeholders would include a nurse, nurse aide, dietitian, and a hospitalist. The primary responsibilities of the nurse consist of completing and documenting skin and risk assessments, monitor progress and/or changes in medical/skin conditions, report patient problems to the hospitalist, and work with the wound team

“Pressure ulcers are key clinical indicators of the standard and effectiveness of care (Elliott, Fox & McKinley, 2008).” L.M. was at high risk for pressure ulcers for multiple factors such as immobility, poor nutrition, age, and health. Therefore, I used the Braden Scale as a quality indicator in order to assess the risk of pressure ulcers and also to

• Nutrition- Mani (2003) claims that nutrition is a fundamental role that must be adopted in the treatment and healing process of pressure ulcers. A balanced diet with adequate nutrients should be key for all patients deemed to be at risk of pressure ulcers. Both nutrition and hydration are the basic components in promoting wound healing and maintaining normal tissue integrity. Patients at risk of pressure ulcers should be nutritionally assessed at regular intervals (Shepard. 2003). This could have been adopted by the use of assessment tools such as, The Nutritional Screening initiative. This tool includes nutritional screening at regular intervals and a comprehensive assessment that includes nutritional assessment, functional assessment and evaluation for depression. This comprehensive approach allows the nurse to quantify the nutritional problems and initiate the appropriate resources that will meet with the individual needs (Bryant, 2000). Another optional tool is the Malnutrition Universal Screening Tool or MUST. This has been designed by the Malnutrition Advisory Group (MAG) of the British

Pressure ulcers during a hospital admission are preventable. Assessment and early intervention can stop skin breakdown before it begins. Many factors regarding Mr. J’s condition placed him at a high risk regarding nursing indicators. Mild dementia, recent fall and a fractured hip all require a high level of nursing care and indicates preventative practice. Upon assessment, precautions should be in place to deter further complications. The elderly are more

While University Hospital is already on the brink of completely preventing pressure ulcers I would still recommend implementing all of the current practices but also add new additions to the team. Currently, we have a wound care team that diligently treats at risk and affected patients. Adding a nutritionist into the team to guarantee treatment from within along with prescribed medications. This will make the team and the strategies multidisciplinary. In addition to that, each treatment should be customized for each patient in regards to cost options and best treatment for their health. The project would also have to be performed repetitively without error to ensure that it is actually helpful. Patients’ skin should continue to be examined thoroughly in common places where ulcers could arise, the standardized pressure ulcer risk assessment should be used, and the proper care should be distributed once evaluated. The team should continue to record its progress and also provide company update emails to inform the facility, as well as send the appropriate data to the higher ups for public posting.

education for the staff on what signs to look for concerning pressure ulcers as well as education on the laws and

Pressure ulcers are a good way for the BSN prepared nurse to teach and educate RNs with an associate degree or diploma and other healthcare staff involved in patient care. This can be accomplished by introducing evidence-based practice information to them. They can be taught how to use to the Braden Scale effectively. They can teach others how to correctly stage and document pressure ulcers. Another important factor is stressing the importance of positioning, pressure-relieving devices, skin care and protection, and nutrition (Agency for Healthcare, 2009).

Pressure ulcers are areas of localised damage to the skin and underlying tissue caused by pressure. (Stechmiller et al., 2008) Pressure ulcers still one of the most significant health problem in our hospitals today, It affects on patients quality of life patient self-image and how long they will stay in hospital then the cost of patient treatment . Moore (2005) estimate that it costs a quarter of a million euro’s per annum to manage pressure ulcers in hospital and community settings across Ireland .which allows one to take immediate actions and prevent the ulcer if possible. To support pressure ulcer risk assessment several standardized pressure ulcer risk assessment scales have been introduced

According to the Agency for Healthcare Research and Quality (AHRQ), 2.5 million patients are affected by pressure ulcers and incur costs anywhere from $9.1 billion to $11.6 billion per year in the United States (AHRQ, 2014). As of October 1, 2008, the Centers for Medicare and Medicaid Services (CMS) will not reimburse hospitals for cases in which the pressure ulcer was acquired after admission (CMS, 2008). Because of this high cost, the number of patients affected each year, and insurances no longer reimbursing hospital acquired pressure ulcers (HAPU), an accurate skin assessment upon admission is critical to reduce costs, ease pain in patients, and lower incidences of pressure ulcers. This paper will address what leadership and management skills and functions are required of a wound care nurse who identifies a problem with the accuracy of skin assessments on newly admitted patients.

It is important to count & track pressure ulcer rates as a major factor for quality improvement. Being able to track pressure ulcer rates, care can be altered to better improve medication interventions and ultimately decrease the rates of pressure ulcers. It also allows the interdisciplinary team members be able to gain perspective on data trends. Improvement efforts are ongoing basis and the AHRQ recommends that pressure ulcer incidence or prevalence rates be monitored to determine outcomes, utilization of at least one or two skin assessments, and determine responsibility for overseeing accuracy of skin assessments.

Critically ill patients are at increased risk for pressure ulcers. Hospital -acquired Pressure ulcers are serious clinical complications and that can lead to increased length of stay, pain, infection and potentially death. Nurses have the primary role in the pressure ulcer prevention. The study assessed nurses’ perceptions of the usefulness and impact of a pressure ulcer prevention care bundle intervention on clinical practice. So it is imperative to understanding nurses’ assessments of interventions when interpreting results and translating evidence into practice.

The fourth study by Iranmanesh, S., Rafiei, H., & Sabzevari, S. (2012) is a Level II clinical trial, which identifies the connection between the Braden Scale assessment and critically ill patient admitted to the trauma ICU. The study monitored patients admitted to the ICU over a three month period which were assessed using the Braden Scale assessment tool. In this study, it was found that the Braden scale was effective in predicting patients at risk for pressure ulcers. The Braden Scale was performed three times a day by trained clinical nurses on eight-two patients who were admitted to the ICU and had no pressure ulcers at the time of admission. Of those admitted eleven patient developed pressure ulcers. The findings of this study found that

Patients get a pressure ulcer for a legion of rationalities. According to Alene Burke of Nursing Assistant Education, some of the elements why people get them which she cited from Nettina, S. (2009), are old age, deficient mobility, lack of moisture, and insufficient diet. Moreover, factors like neurological and other physical problems, friction and shearing, bed and chairs with wrinkled linens or hard objects and pressure ulcers in the past may similarly predispose pressure ulcer. This observations implies that in nursing care pressure ulcers are prospected as negligence, however it is arrogated that pressure ulcers are avoidable on the condition that prime level of care is continuously rendered to patients and residents. (Burke 2010).