Wait a second!
More handpicked essays just for you.
More handpicked essays just for you.
What is risk management in healthcare
Case study pressure ulcer prevention
Short note on risk assessment
Don’t take our word for it - see why 10 million students trust us with their essay needs.
Recommended: What is risk management in healthcare
Introduction
The aim of this assignment is to analyse the role of the nurse in relation to Risk Management, In order to do this effectively, recognised risk assessment tools will be utilised, various measurements have been put in place to minimise the risk to patients who come into contact with health services in both primary and secondary care settings, the specific subject the author will explore is pressure ulcers, definitions will be offered throughout the assignment to assist the readers understanding of terms such as risk and risk assessment, as well as the importance of nutrition and the detrimental effect malnutrition can have on pressure ulcers, the causes and the aims of preventing them through the use of appropriate assessment tools, along with statistics, policies and guidelines, including the five steps that should be taken to carry out efficient risk assessments. Harrison (2003) describes risk assessment as “an assessment that can identify those at risk”, so that steps can be taken to provide appropriate therapeutic treatment.
Rationale
The National Health Service (NHS) 2010 describe a pressure ulcer as a “decubitis ulcer a bedsore, ulceration of the skin due to pressure”, which can cause interference with the blood supply to the area, however the European Pressure Ulcer Advisory Panel (EPUAP) describe it as “An ulcerated area of the skin caused by the continuous pressure on part of the body in a bedridden patient”. As these definitions clarify, a pressure ulcer is a universal but
potentially an avoidable condition presenting most often in high risk patients such as elderly and those with physical impairments, therefore carrying out risk assessments could potentially prevent them, the a...
... middle of paper ...
...th March 2011].
Thompson, D. 2005, “Tissue Viability”, An evaluation of the Waterlow Pressure Ulcer risk assessment tool, British Journal of Nursing, Vol. 14, pp. 455-459.
Wade, C. Wolf, S. Salinas, R. Jones, J. Rivers, R. Hourigan, L. 2010, “Loss of Protein, Immunoglobulin’s, and Electrolytes in Exudates from Negative Pressure Wound Therapy”, Nutrition in Clinical Practice, Vol. 25, no. 5, pp. 345-350.
Walsh, B. & Dempsey, L. 2010, “Assessment Scale”, A literature Review Investigating the Reliability and Validity of the Waterlow Risk Tool, Clinical Nurse Journal, Vol. 10, pp. 387-390.
Waterlow Pressure Ulcer Prevention Policy, 2005, [Online]. Available from: http://www.judy--waterlow.co.uk/the-waterlow-manual.html [Accessed 14th March 2011].
Williams, L. Leaper, D. “Nutrition and Wound healing”, 2006, Clinical Nutrition Update, vol. 5, no.1, pp.3-5.
In nursing practice, the safety competency is all about doing no harm to the patient and provider often by following the right procedures and monitoring the system’s performance for efficiency, as well as ensuring peak individual performance amongst the practitioners and their support systems. Integrating safety into the nursing practice, education and research is paramount to the effectiveness of the profession in so many ways as will be discussed in this paper. But before that, it is necessary to consider the knowledge, skills and attitudes that are related to this particular competence. The paper will then discuss the implications of integration with respect to the working environment.
In each nation one urban intense care hospital setting was chosen to take part. A clinical site in Ireland connected with formal organized risk assessment utilizing the Maelor Score while in Norway they utilized clinical judgment alone. Firstly, they started with data collection, which was about making checklist data related to pressure ulcer risk assessment, prevention practices and patient education. This particular checklist was utilized effectively within the Irish health-care setting and commonplace to the research group. All patients were estimated for risk using the Braden pressure ulcer risk assessment tool.22 PUs were assessed using the European Pressure Ulcer Advisory Panel (EPUAP ) pressure ulcer grading system.23 In Norway, five nurses were given a half-day instruction session. These sessions associated to pressure ulcer risk assessment, grading, propagation, and information accumulation with reference to the checklist utilized for this study. Information were gathered more than one day in each
With noticeable increase in chronic diseases, trauma, and increasing number of aging population, nurses are required to be in the position of providing pressure ulcer care and prevention. Immobility, advanced age, incontinence, prolonged pressure or friction, inadequate nutrition, dehydration, anemia, hypoxemia, multiple comorbidities, sensory deficiency, thin skin, prominent bony prominences, circulatory abnormalities, pain, and smoking are important risk factors. The barriers in the implementation of preventive measures are staff shortage, shortage of pressure relieving devices (e.g., foam or air mattresses), excessive workload, and uncooperative patients. The Centers for Medicare and Medicaid Services has classified the pressure ulcers as a preventable Hospital Acquired Conditions and stopped reimbursing for such hospital acquired conditions. In the United States, the cost of an individual patient care per pressure ulcer includes skin cleanser, moisturizer, dressings, wound debridgement, antibiotics, analgesics, turning sheet and support surfaces, nursing time for risk assessment, monitoring, and repositioning. It is the second most common claim after wrongful death and greater than falls or emotional distress. No matter what causes the pressure ulcers, the presence or absence of pressure ulcers is generally regarded as a performance measure of quality nursing care and overall patient health. Pressure ulcers can be avoided by applying simple interventions like factor assessment scales and regular turning of the patient. Proper hydration, a balanced diet, activity, wound care, and keeping patient’s skin and body dry are treatment, as well as, preventive measures of this problem. A thorough physical assessment, risk assessment (using a risk assessment tool like Barden scale), repositioning, patient and caretaker education, effective communication, and
Pressure ulcers are one of the most common problems health care facilities often face which causes pain and discomfort for the patient, cost effective to manage and impacts negatively on the hospital (Pieper, Langemo, & Cuddigan, 2009; Padula et al., 2011). The development of pressure ulcers occur when there is injury to the skin or tissue usually over bony prominences such as the coccyx, sacrum or heels from the increase of pressure and shear. This injury will compromise blood flow and result in ischemia due to lack of oxygen being delivered (Gyawali et al., 2011). Patients such as those who are critically ill or bed bounded are at high risk of developing pressure ulcers (O'Brien et al., 2014).
Stress ulcers were first identified in 1970 by Skillman and Silen and reported as a clinical syndrome of lethal “stress ulceration” in a 7 out of 150 patients in intensive care (ICU). These reports showed superficial ulcers in the gastric fundus area of the stomach.1 Forty years later, Stress ulcers are still defined by distinct bleeding and interrupted circulation of blood to the fundus region. Skillman and
Many nurses face the issue of understaffing and having too much of a workload during one shift. When a unit is understaffed not only do the nurses get burnt out, but the patients also don’t receive the care they deserve. The nurse-patient ratio is an aspect that gets overlooked in many facilities that could lead to possible devastating errors. Nurse- patient ratio issues have been a widely studied topic and recently new changes have been made to improve the problem.
The field of nursing is one that requires much passion, hard work and critical thinking. It is a nurses job to promote the well being of their patients and help the return to normal function. However unfortunate events occur, resulting in patients receiving adverse health conditions as a result of being in a medical facility One of the most prevalent of these nosocomial conditions are pressure ulcers. Not only do the patients suffer from the pain of pressure ulcers but the hospitals and medical facilities are effected as well. A randomized controlled trial conducted by Pickham et al. reported that “ Pressure ulcers are insidious complications that affect approximately 2.5 million patients and account for approximately US$$ 11 billion in annual health care spending each year” (2016). Pressure ulcers not only cause the patient pain but “even contribute to disability and
The curcumin (69±8.7), laser (85±12), and laser + curcumin (88 ±7.9) treated groups significantly enhanced wound closure, compared to the control group (139.8 ±20.2), (One-way ANOVA, LSD test for all groups, p=0.000). We have observed that the curcumin treated group had significantly enhanced wound closure, compared to the l aser + Curcumin group ( LSD test, p=0.033)(Figure2).
Answer: "Pressure ulcers, formerly called bedsores or decubitus ulcers, develop from continuous pressure that impedes capillary blood flow to skin and underlying tissue. Several factors contribute to the formation of pressure ulcers, but impaired mobility and urinary incontinence are key" (Mahan, L., Escott-Stump, S., Raymond, J., & Krause, M.,2012). In addition, "paralysis, incontinence, sensory losses, and rigidity can all contribute to the problem. Notably malnutrition (inadequate protein) and undernutrition (inadequate energy intake) set the stage for its development and can delay wound healing. The escalating chronic nature of pressure ulcers in bed-ridden or sedentary elderly requires vigilant attention to nutrition" (Mahan, L.,
The Braden Scale demonstrated both sensitivity and specificity in risk assessment of pressure ulcer development (VandenBosch et al., 1996). In order to maximize the intervention, it is important that nursing personnel are thorough in skin assessment evaluation and can accurately identify and stage lesions. For future research, it is recommended that a consistent cut-off value be continually updated to determine at risk-hospitalized patients. As previously discussed, a current cut-off value of 18 is used which places patients in a mild risk category of the Braden Scale (Braden & Makleburst, 2005). In this health care practice area, the RN cannot overlook physical assessment. It is recommended that all future research include a proper skin assessment in accordance with hospital policy and procedure. While evidence shows that the Braden Scale is an effective risk assessment tool, it should not stand in for traditional nursing assessment, but rather be used as a tool to help determine at risk patients that are may be in need for further intervention. It is a recommendation that future research study also discuss surgical procedures in relation to the Braden Scale and possible pressure ulcer development. According to Schoonhoven et al. (2002), surgery is considered a risk factor
The Quality and Safety Education for Nurses (QSEN’s) goal is to prepare future nurses with the knowledge, skills, and attitudes (KSAs) that are needed to continuously improve the quality and safety of the healthcare systems within which they work. QSEN focuses on six main competencies; patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. As we have learned in earlier classes these competencies and their KSAs offer a base to help us and other nurses as we continue our education and become RNs. As we will learn in this class these KSAs go hand in hand with health assessment.
As conversed throughout this case, nurses play a vital role in the health care setting. They are those who are there from the beginning to the end to improve quality of life for each individual. Nurses peruse quality of life by performing specific appropriate for the client; these include assessment tools, setting goals and interventions to provide the best possible outcome. Thus, the importance of this case is to demonstrate the nursing skills regarding to an individual and their health situation. Allowing the nurse to enhance the quality of care and ensuring safety at all times is achieved for the individual and overall performance.
The reduction of pressure ulcer prevalence rates is a national healthcare goal (Lahmann, Halfens, & Dassen, 2010). Pressure ulcer development causes increased costs to the medical facility and delayed healing in the affected patients (Thomas, 2001). Standards and guidelines developed for pressure ulcer prevention are not always followed by nursing staff. For example, nurses are expected to complete a full assessment on new patients within 24 hours at most acute-care hospitals and nursing homes (Lahmann et al., 2010). A recent study on the causes of pressure ulcer de...
Pressure ulcers have been identified as a common and worldwide health problem that continues to cause pain and discomfort to patients. The costs of treating pressure ulcers are high. The cost for healing one deep ulcer has been estimated between -----. However, most cases of pressure ulcers are predictable and preventable. In HP2020, under the new category of The Older Adult/Injury Prevention, Objective OA-10 aims to reduce the rate of pressure ulcer-related hospitalization among older adults. Older adults tend to develop pressure ulcer due to lack of mobility, lack of sensation, poor nutrition and hydration, and other health problems affecting blood flow. It is important to assess hospitalized patients for these risk factors and implement
Malnutrition can quickly develop due to the catabolism that occurs from critical illness, and secondary infections and impaired skin integrity can occur from such malnutrition. Therefore, it is vital that nutrition is started quickly with minimal interruptions to reduce