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Executive summary on pressure ulcers
Case studies of pressure ulcers
Nursing, case study, pressure ulcers
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Recommended: Executive summary on pressure ulcers
Roles of the Registered Nurse (RN) are ever changing where it is key to continue to educate for the protection and well being of the patient. Pressure ulcers have become a main issue in healthcare in an attempt to lower cost as well as prevent further morbidities and complications for the patient. According to the National Institute of Health (NIH) a pressure ulcer is defined as an area of skin that breaks down when something keeps rubbing or pressing against the skin. An increase in immobile and elderly patients has increased the risk for the development of pressure ulcers. The education and prevention of pressure ulcers should be implemented as a key goal for a nurse during the care of a patient.
Pressure ulcers is tissue damage that occurs when the epidermis and softer underlying tissue is pressed up against a bony prominence for extended periods of time. (Ignatavicius, 2013) The pathophysiology behind the development of a pressure ulcer is the compression on blood vessels, which in turn restrict blood flow to the tissue leading to a decrease in tissue perfusion and oxygenation with an end result of cell death. (Ignatavicius, 2013) Pressure ulcers can occur anywhere on the body however it is most common over the sacrum, hips, and ankles due to the common position of the body residing on those bony prominences. Tubing and cords are another common source of pressure ulcers, such as lying on a Foley catheter tubing or having a nasal cannula that is to tight around the patient. As with most prevention and healing of illness or disease, proper nutrition plays a large role in pressure ulcers. Nurses must be aware of the mechanical forces that can put a patient at risk for or create a pressure ulcer. Friction is when a surface ru...
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...ng assistant and in turn free up time for the nurse to care for other aspects of the patient. Monitoring and assessing high-risk areas for development of pressure ulcers of these patients was a necessity at least once every shift. More frequent turning and positioning was needed due to the complete immobility of these patients. I found that the diligence and expertise of these nurses, combined with the continuance to gain knowledge, helped prevent pressure ulcers from developing or progressing.
Even the most experienced nurse must continue to gain knowledge to ensure proper safety for their patients. The use of evidence based practice to evolve the current prevention strategies will help make sure the best care is given to the patient. The nursing profession will only succeed with the continuation to gain knowledge and implement proper protocols for the client.
Risk assessment scales have been in situ for over 50 years within the adult sector. These scales consist of several categories, which are thought to be associated with the potential occurrence of a pressure ulcer. Factors such as mobility and incontinence etc. are considered. Each category of the assessment is added up to give a total. The score then suggests whether a patient is at low, medium or high risk of developing a pressure ulcer. Higher-risk patients are therefore more susceptible to develop pressure ulcers and interventions are implemented such as, Air mattresses or nutritional support which is hoped to reduce the occurrence of pressure
Currently health care facilities use individual, multi-component interventions, or series of interventions to prevent pressure ulcers. Either health care staff is not implementing these strategies into their patient’s care or some changes obviously need to be made. Interventions to prevent pressure ulcers consist of using the Braden Scale for initial and repeated skin assessments to determine the patient’s risks for pressure ulcers, specialized support mattresses, heel supports, and frequent repositioning for bed bound patients, encouraging mobility, moisture management, nutrition, hydration, and reducing friction or shear forces on parts of the body at increased risk for pressure ulcers (Sullivan & Schoelles, 2013).
Hinkle, J., Cheever, K., & , (2012). Textbook of medical-surgical nursing. (13 ed., pp. 586-588). Philadelphia: Wolters Kluwer Health
Nurses have many different roles which include promoting health, preventing illness, and the daily care of patients in all different kinds of settings. It is important for nurses to treat the whole patient and address not only the acute concern but all factors that contribute to the patients’ health and well-being. We are each responsible for our health, and it is the role of the nurse to help their patients be accountable for their health. Nurses have also to ensure
Safety is focused on reducing the chance of harm to staff and patients. The 2016 National Patient Safety Goals for Hospitals includes criteria such as using two forms of identification when caring for a patient to ensure the right patient is being treated, proper hand washing techniques to prevent nosocomial infections and reporting critical information promptly (Joint Commission, 2015). It is important that nurses follow standards and protocols intending to patients to decrease adverse
Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2010). Brunner & Suddarth’s textbook of medical-surgical nursing (12th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Additionally, the LPN cannot push medications into a peripheral intravenous line if the patient “weighs less than 80 lbs, is prenatal, pediatric, or antepartum”, although given that the situation is on a general med-surg floor it is unlikely these patients would be under Sarah’s care at this time. (Rules and Regulations of Practical Nurses. 2015) Sarah can delegate the postoperative patients who need dressing changes and ambulating them to the LPN, but Sarah should assess the wounds for complications initially and serve as resource to the LPN if she has questions about the wounds. Additionally, she could help the nursing assistant with answering calls and serve as a reference for the nursing assistant to ask questions or help with tasks if Sarah is not available. With regards to supervision, the LPN would need continuous supervision given that the working relationship is new. (Cherry and Jacob, 2014) Sarah should be available and willing to answer any questions or address any concerns the LPN
Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for the delivery of optimal health care (qsen.org). Like most medical professions, nursing is a constantly changing field. With new studies being done and as we learn more about different diseases it is crucial for the nurse to continue to learn even after becoming an RN. Using evidence-based practice methods are a great way for nurses and other medical professionals learn new information and to stay up to date on new ways to practice that can be used to better assess
As an ICU nurse I constantly watch how patients develop pressure ulcers, a pressure ulcer is an area of skin that breaks down due to having constant friction and pressure, also from having limited movement and being in the same position over a prolonged period of time. Pressure Ulcers commonly occur in the buttocks, elbows, knees, back, shoulders, hips, heels, back of head, ankles and any other area with bony prominences. According to Cox, J. (2011) “Pressure ulcers are one of the most underrated conditions in critically ill patients. Despite the introduction of clinical practice guidelines and advances in medical technology, the prevalence of pressure ulcers in hospitalized patients continues to escalate” (p. 364). Patients with critical conditions have many factors that affect their mobility and therefore predispose them to developing pressure ulcers. This issue is significant to the nursing practice because nurses are the main care givers of these patients and are the ones responsible for the prevention of pressure ulcers in patients. Nurses should be aware of the tools and resources available and know the different techniques in providing care for the prevention of such. The purpose of this paper is to identify possible research questions that relate to the development of pressure ulcers in ICU patients and in the end generate a research question using the PICO model. “The PICO framework and its variations were developed to answer health related questions” (Davies, K., 2011).
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...
ANA describes “The Scope of Nursing Practice (as) the “who,” “what,” “where,” “when,” “why,” and “how’ (8).’ In other words, it is the responsibility of the nurse to know who their patient is, what the patient’s diagnosis and treatment are, where it is they will be delivering treatment, the rationale behind their actions, and how they will deliver the care. By following the scope of practice, nurses reduce avoidable errors and are aware of the liability their actions entail. The ANA also puts forth a nursing process to guide nurses in treatment. The constantly evolving process is currently assessment, diagnosis, identification of outcomes, planning, implementation, and evaluation (ANA 9). Though this method has dramatically improved nursing care, it may be necessary to repeat steps to adapt to a patient’s changing needs and pathologies. By following guidelines set by the ANA, nurses are able to better connect with their patients and instill the image of professionalism to the public while also optimizing safety
A registered nurse is a critical piece of the support system for injured and sick patients. Nurses are greatly valued in the health care system because they have many and varied responsibilities within hospitals and clinics, including: patient care, administration of medications; communication with other health care providers, patients and patients’ families; and education of patients, family members, and new nurses in training (Isaac, 2014).
The overall goal for the Quality and Safety Education for Nurses (QSEN) plan is to meet the challenge of educating and preparing future nurses to have the knowledge, skills and attitudes that are essential to frequently progress the quality and safety of the healthcare systems in the continuous improvement of safe practice (QSEN, 2014).Safety reduces the possibility of injury to patients and nurses. It is achieved through system efficiency and individual work performance. Organizations determine which technologies have an effective protocol with efficient practices to support quality and safety care. Guidelines are followed to reduce potential risks of harm to nurses or others. Appropriate policies
My nursing career began 7 years ago at SSM on Medical Oncology Unit. I was certified in Chemotherapy and Wound Care. Although there were thirty staff nurses, only two of us were certified in wound care and five were chemotherapy certified. Besides caring for my medical-surgical patients, I was also responsible for administering chemotherapy and monitoring cancer patients as well as assessing, documenting, and recommend the appropriate treatments for different types of types of wounds, including surgical openings, ulcers, bed sores, feeding tube sites, and abscesses. I gained a diverse range of clinical skills in Emergency Department, Cardiology, Neurosurgery, and Orthopedic Surgery as floating was a staff nurse's requirement. Every nursing
The nursing profession is constantly in a state of change becoming more complex over time. Registered nurses work to prevent disease, promote health and help patients cope. They develop and manage nursing care plans, instruct proper outpatient care, and help improve and maintain health within their community. They are educators of health governed by state laws. Registered nurses can work in many different settings which determine their daily job duties. Depending on their level of training a RN could work with geriatrics, in intensive care units, as an educator, as clinical study observers, a midwife, oncology, or palliative care. Hospital nurses make up the majority of the RN group. They work as staff nurses who carryout medical regimens and provide bedside care. Most registered nurses work in well-lighted comfortable facilities, work nights, weekends, and holidays, and spend a considerable amount of time on their feet. They have to be available at a moment’s notice. Nursing also has its hazards all employees of care facilities are at risk for infectious disease, radiation poisoning, back injuries, shocks from electrical equipment, and hazards posed by compressed gas. Nurses are the link between doctors and patients.