Effectiveness of Risk Assessment in Preventing Pressure Ulcer - Research Paper Example

?Effectiveness of Risk Assessment in Preventing Pressure Ulcer Research Question 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. The objective of the study will be as follows: To assess whether incorporating risk assessment in nursing practice can reduce the prevalence of pressure ulcers; Establish whether risk assessment can reduce the overall preventive measures used on a patient Investigate whether the detection of pressure ulcers in its early stages could reduce its severity and prevent other illnesses from developing. Background Pressure ulcers are local injuries to skin and/or underlying tissues due to pressure from an object pressing and/or rubbing against the skin. Pressure usually leads in insufficient blood flow and occurs mostly in bony areas such as the sacrum, coccyx, hips, and heels. Insufficient blood supply can lead to death of skin cells leading to the formation of an ulcer. In the US, the prevalence of pressure ulcers varies among states widely, with some states such as Ontario recording incidence rates of 53% in poorly managed healthcare institutions (Clarke, Bradley, & Whytock, 2005). This results in additional costs for patients, caregivers, and the overall healthcare system. For instance, the UK spends between 1.4 and 2.1 billion pounds to treat pressure ulcers while in Australia, it costs approximately AUS $61,000 to treat a stage four pressure ulcer (Frantz, Gardner, Harvey, & Spetch, 1991). In the US, treatment cost per ulcer can range between $10,000 and $86,000. Although various interventions have been implemented in the prevention and treatment of ulcers, there is little research data regarding the effectiveness of measures adopted. Method a) Population The research will be conducted among patients in government, institutional and private hospitals that handle inpatients. b) Intervention The study will use interventional (or experimental) procedure. Nursing personnel will be trained on how to assess risk among patients and mitigation measures that can be taken to prevent pressure ulcers. The staff will also be trained on early detection of the injuries. c) Comparison Data on patients at risk from developing pressure ulcer will be collected before and after training. The data will also include the number of patients who will develop ulcers over a four-week period before and after the training intervention. Data collected after nursing staff have undergone training will be compared to that collected before the training using various statistical analyses to determine whether there was a significant decline in the number of patients at risk of developing ulcers. d) Outcome Results of the analysis will also indicate whether training of nursing personnel in the assessment of pressure ulcer risk is effective in reducing the number of patients developing pressure ulcers. e) Time The study will run for a period of three months. Data on the number of patients developing ulcers and those at risk will be collected for a period of four weeks followed by training of personnel. Data will be collected again after training for a period of four weeks. Critique of Literature Clinical studies have shown that development of pressure ulcer during hospitalization can be alleviated by adopting appropriate mitigation measures (Severens, Hobraken, Duivenvoorden, & Frederiks, 2002; Vanderwee, Clark, Dealey, Gunningberg, & Defloor, 2007). These measures can include the development of methods and ways of determining risk factors. Early action can alleviate pain and improve quality of life among persons at risk or those already affected. Healthcare institutions can also benefit from early detection of pressure ulcers by reducing fiscal and time expenditure on the care and treatment of patients. Clarke et al. (2005) mention that pressure ulcers directly kill at least 60,000 persons per year in the US. These figures could be inaccurate due to the difficulty of directly attributing a death to pressure ulcers and not the illness due to which the patient was admitted. Hence, disease becomes a confounding variable. Frantz et al. (1991) stress that bedridden and aged patients are at the highest risk of contracting pressure ulcers. However, focus must also be directed to infants and children. Consequently, all patients must be assessed on admission to determine their risk factors and monitor them constantly to ensure they do not develop ulcers. Nursing personnel must identify and relieve pressure on body parts susceptible to pressure ulcers and assist in reducing chances of developing the injuries. In addition, monitoring bowel and urinary movement of immobile patients can ensure that the risks of developing pressure ulcers are reduced. One weakness of most studies related to alleviation of pressure ulcers is the lack of a clear procedure for assessing the effectiveness of the interventions investigated. Research Proposal As a result of a gap in research in pressure ulcers on a precise procedure for determining the effectiveness of various interventions, the author intends to carry out a study on the same. The research will run for around three months in government, institutional and private hospitals so that the final data collected are representative of all classes of healthcare facilities in the country. The study will use interventional (or experimental) procedure that will involve training of nursing personnel on early detection, risk assessment, and mitigation measures that can be taken to prevent pressure ulcers. Data will be collected before and after the training and statistical methods used to make inferences. Conclusion Pressure ulcers are known causes of death among at-risk patients admitted in healthcare facilities. Due to the rising prevalence of these injuries, studies have focused on development of methods and ways of determining at-risk populations, risk factors, and early detection methods. This proposal seeks to investigate the effectiveness of risk assessment in preventing pressure ulcers. References Clarke, H. F., Bradley, C., & Whytock, S. (2005). Pressure ulcers: Implementation of evidence-based nursing practice. Advanced Nursing, 49(6), 578–590. Frantz, R. A., Gardner, S., Harvey, P., & Spetch, J. (1991). The cost of treating pressure ulcers in a long term care facility. Decubitus, 4, 37-42. Severens, J. L., Hobraken, J. M., Duivenvoorden, S., & Frederiks, C. M. (2002). The cost of illness of pressure ulcers in the Netherlands. Adv Skin Wound Care, 15(2), 72–77. Vanderwee, K., Clark, M., Dealey, C., Gunningberg, L., & Defloor, T. (2007). Pressure ulcer prevalence in Europe: A pilot study. Journal of Evaluation in Clinical Practice, 13(2), 227–235. Read More