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Impact of implementing clinical practice guidelines to prevent pressure ulcers - Literature review Example

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Impact of implementing clinical practice guidelines to prevent pressure ulcers

The paper tells that over the years, researches and similar works have recognised the ill effects of extended immobility. In fact, Clavet, et al. found that immobility leads to skeletal degeneration, while Smorawiński, et al. found that immobility causes oxygenation problem. In addition, Paddon-Jones, et al. revealed that patients who stay bedridden for a long period of time experience loss of muscle mass, the severity of which depends on the length of immobility. Still, among the most adverse effects of immobility is the development of pressure or decubitus ulcers. Pressure ulcers are usually caused by the shearing effects of friction against the skin surface constantly in contact with the bed or mattress. They are a major concern for healthcare professionals because of their impact on the patient, the costs and challenges they present to the healthcare delivery system, and because of their prevalence and severity. Indeed, in the United States alone, around one million individuals develop pressure ulcers. Bedsores are also most commonly found in elderly individuals, both in hospitals and nursing homes or similar institutions. According to Park-Lee and Caffrey, 11 percent of nursing home residents (or 159,000 patients) developed pressure ulcers in 2004. Patients who are around 64 years of age are more prone to developing pressure ulcers, the most common of which is Stage 2 bedsores. Moreover, in terms of severity, the same authors noted that pressure ulcers have been observed as the direct cause of death in around eight percent of paraplegic patients. Finally for the United States, Cuddigan, Berlowitz and Ayello (2001) revealed that around 60% of quadriplegics, 25% of nursing home residents, and 10% if all hospital patients all develop bedsores. In the United Kingdom (UK), Clark, et al. (2004) found that one in five admitted hospital patients has, or is developing, a pressure ulcer. This statistic translates to around 20,000 inpatients in the UK at any given time. As for residential settings, although not much documentation is available, patients are constantly referred to the healthcare system for solutions or interventions. Moreover, around 400,000 patients develop a new bedsore every year in the United Kingdom. This high prevalence of pressure ulcers has also been observed in hospitals and other settings in Ireland. In the study by Gallagher, et al. (2008), the authors found that in three university teaching hospitals, around 18.5% of patients have developed pressure ulcers. Of these, 77% are hospital-acquired, and 49% are grade one. Also, in another study by Moore and Cowman (2011), it was revealed that in the Republic of Ireland, the prevalence rate of pressure ulcers is nine percent. Although relatively low, this percentage is made complicated by the fact that the greatest percentage of the documented cases are grade two sores (33%), mainly located on the heel (25%) and on the sacrum (58%). Also, around 53% of the study’s respondents were completely immobile or had very limited mobility. Other than the risk posed by its prevalence, pressure ulcers also present challenges to the individual and the community. For the patient and his/her family, much pain and discomfort is caused by the presence of pressure ulcers. Indeed, according to the Institute of Medicine (2001), pressure ulcers hamper the patient’s recovery, as well as cause unnecessary strain on the caregiver. For the community, pressure ulcers also present challenges in terms of costs. In terms of costs, pressure ulcers drain a lot of financial resources for the healthcare sector. In the US, for example, around $1 billion was used in 2004 for the treatment of pressure ulcers. Similarly, in the UK, the NHS spends around ?1.8-2.6 billion on hospitalisations and treatments involving pressure ulcers or ...Show more

Summary

This paper will explore different implementing clinical guidelines for pressure ulcer prevention and treatment, as well as the impacts of these guidelines. In addition, this paper will also present some of the methodological issues of the studies reviewed…
Author : jrosenbaum
Impact of implementing clinical practice guidelines to prevent pressure ulcers essay example
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