to develop pressure ulcers because skin constitution changes as one gets older becoming thinner with less collagen and with diminished capability to protect itself from the bacteria and the environment. Once the skin succumbs to bacteria or sustains injuries from friction and shear, healing takes longer because reduced flow of blood brings nutrients and removes wastes more slowly. Ischemia due to unrelieved pressure is usually observed in the elderly, malnourished patients, patients reduced to immobility because of their medical condition, fecal incontinence, and patients under less than conscious condition (Mauk 2009, p. 501).
In 2004, the National Home Survey reported that for every 10 residents in nursing homes all over the United States, 11% have succumbed to pressure ulcers with stage 2 pressure ulcer as the most common (see Fig. 2). Both whites and non-whites had equal percentage with the males edging the females at 13% and 10%, respectively (Park-Lee & Caffrey 2009). In 2007, the Centers for Medicare and Medicaid Services reported some 257,412 preventable pressure ulcers as secondary diagnoses at cost averaging at $43,180 for every stay in the hospital. This compelled Medicare to give up shouldering pressure ulcer costs so as to encourage its prevention (Mauk 2009, p. 501).
The Institute for Healthcare Improvement has recommended a set of simple interventions collectively known as ‘bundle’ for pressure ulcers prevention in 2003. Hospitals are encouraged to develop their own “bundle” in approaching pressure ulcer prevention (Paciella 2009, p. 43). The SKIN bundle, which is an acronym for Surface, Keep Moving, Incontinence and Nutrition, was developed by the Ascension Health facilities in 2004. In the succeeding pages a sample of change in practice program is outlined for a fictitious hospital ward called HTMC for the prevention of pressure ulcer using the SKIN bundle.
In the first quarter of 2010, the East Wing 13 of the HTMC had reported 27% ...
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254). The “bony prominence” areas where pressure ulcers usually form are the sacrum, coccyx, hips and heels. Older people have a tendency to develop pressure ulcers because skin constitution changes as one gets older becoming thinner with less collagen and with diminished capability to protect itself from the bacteria and the environment.
One of such health problem is Pressure Ulcer. In conformity to the explanation by the Arkansas State University College of Education (2008), the theoretical framework of most of the sources discussed in this review “establishes a vantage point, a perspective, a set of lenses through which the researcher views the problem.” Generally, the deep tissue injury theory was used by researchers with the view that ulcers occur, starting from areas around the bone till they get to the epidermis – thus beginning from the deepest level.
Being confined in the hospital is normally not a wanted experience, but when a patient does go to a hospital, or when they are somehow required to stay there for a length of time, normally, patients expect a level of care from the medical staff as well as a level of sanitation and cleanliness that prevents complications or further issues from occurring.
Braden scale evaluates the level of risk for getting pressure ulcers and those discovered to have or at risk of developing the ulcers are given preventive care. According to Braden (2009), the Braden scale consists of six subscales/areas that can be completed in one minute.
However, guidelines are meant to be modified or adapted depending on the situation. It is thus vital to consider the capabilities of both the caregiver and the setting to implement all the steps. Goals should be set, from which the success of the guideline is compared to.
Effectiveness of Risk Assessment in Preventing Pressure Ulcer. The research question for the study will be: Does increased risk assessment and early detection reduce the prevalence of pressure ulcers in healthcare institutions? The independent variable is risk assessment and detection of ulcers while the independent variable is prevalence of ulcers.
Braden scale evaluates the level of risk for getting pressure ulcers and those discovered to have or at risk of developing the ulcers are given preventive care. According to Braden (2009), the Braden scale consists of six subscales/areas that can be completed
This begs the question why its nearly impossible to have a sustained pressure ulcer prevention in the geriatric patient. This research topic tends to settle down this question by determining the attitude and knowledge of nurses on geriatric