Pressure ulcers present a major health problem, particularly for immobilized older adults. The prevalence of pressure ulcers increases with age. Age is the most predisposing risk factor for development pressure ulcers among other risk factors. According to the Centers for Disease Control and Prevention (CDC), the prevalence of pressure ulcers for hospitalized patients range from 2.7 to 29.5% and greater of more than 50% have been witnessed in intensive care units (ICUs) (Sewchuk, Padula, & Osborne, 2006). The National Center for Quality established National Database of Nursing (NDNQI) which provides a benchmark for quality indicators including pressure ulcers. Immobilized patients have increased the risk of developing pressure ulcers. Development of pressure ulcers is directly associated with tolerance of tissue pressure, and intensity and duration of that pressure. Tolerance of the tissue under pressure reflects the supporting structures and the ability of skin to tolerate the effect of pressure. Various interventions such as the use of pressure-reducing surfaces and intraoperative prevention are used to prevent pressure ulcers. This paper seeks to explore how prevention of pressure ulcers has the potential to improve the quality, safety, and outcomes of patients and families.
Importance Prevention of Pressure Ulcers
Monitoring and protecting the condition of patient’s skin helps to improve patient’s safety, quality of life and outcomes. The starting point in preventing pressure ulcers is risk assessment (Sewchuk, Padula, & Osborne, 2006). A structured risk assessment tool can be used to identify patients at risk of developing pressure ulcers as early as possible. The use of a risk assessment tool helps to promote patient safety by identifying a patient’s risk of developing a pressure ulcer.
Pressure ulcers can also be prevented through skin care. Monitoring and protecting the skin of a patient is important for preventing pressure sores. Healthcare providers can inspect for signs of pressure injuries and clean hospitalized patient at least daily using skin moisturizers and skin cleansers that a PH balanced for the skin. Skin care also involves avoiding positioning the patient in the area of pressure injury (Sewchuk, Padula, & Osborne, 2006). This intervention for preventing the development of pressure ulcers helps to improve the quality of life of the patient and patient outcomes.
Pressure ulcers can also be reduced through nutrition. Hospitalized patients are at high risk of undernutrition. The healthcare provider can use a valid tool to examine a patient’s risk for malnutrition. Patients at risk can be referred to a registered nutritionist or dietician. The patient’s weight can also be assessed to determine their risk for malnutrition (Sewchuk, Padula, & Osborne, 2006). This intervention for pressure ulcers has the potential to improve the quality, safety, and outcomes of patients and families by improving their general health.
Pressure ulcers can also be prevented through positioning and mobilization. Immobility is a primary factor which causes pressure ulcers and can be due to various factors including paralysis, sedation, general poor health condition, age, and coma. Caregivers are required to reposition and turn at-risk patients if not contraindicated and provide a support surface for the patient (Sewchuk, Padula, & Osborne, 2006). They are also encouraged to design a scheduled frequency of repositioning and turning the patient.
Available data and leadership’s goal for improvement
Although various strategies have been set up to prevent and reduce the prevalence of pressure ulcers, they remain a major problem, particularly for immobilized older patients. Quantitative research has shown that implementation of quality improvement within an organization can be challenging without the right monitoring, training and leadership support (Sewchuk, Padula, & Osborne, 2006).
Implementing strategies for preventing pressure ulcers requires healthcare providers to monitor the incidence and prevalence of pressure ulcers. All members of the interdisciplinary team should also be educated and trained to ensure that they are aware of the plan for care and all care is recorded in the patient’s chat. To achieve the goal of prevention of pressure ulcers, there should be an adequate allocation of resources, oversight, and leadership support (Sewchuk, Padula, & Osborne, 2006).