Wednesday, November 30, 2016

Evidence based on pressure ulcers




There is a problem at many hospitals, nursing homes, and rehabilitation centers. I’m talking about pressure ulcers, specifically, hospital acquired pressure ulcers. As you are all aware, pressure ulcers occur because these patients are not able to move independently, especially those suffering with neurological or cognitive impairments and the elderly. Many are no longer able reposition themselves in bed or in a wheelchair. Often, they have to lay in bed waiting for someone come and position them from side to side. Some are unable to feed themselves which contributes to the problem and increases their risk of getting a pressure ulcer because of the nutritional and hydration deficiencies. Many of these patients are incontinent and the amount of time that they have to sit in urine or feces contributes to the problem as well. These pressure ulcers appear to be painful, grotesque, and have a great risk of acquiring an infection and as the population rises the problem so does the problem.

What can be done? I believe that most of the hospital staff does what they can to prevent pressure ulcers using various preventative techniques from repositioning the patient often, using pressure relieving mattresses, making sure the patient is well-hydrated, eating appropriately, and being cleaned up after an incidence of incontinence. I still feel that more can be done and quite frankly I think it has to be done for the quality of life for these patients!

Hospitals and other facilities spend thousands of dollars on each patient attempting to heal a pressure wound, but wouldn’t it be better if the pressure ulcers were prevented before they begin. In the attached article they highlight there prophylactic use of dressings for pressure ulcer to prevent pressures. They also discuss how the facilities have a “shift in culture from cure to prevention”. In the article it says “Of the 93 patients were included in the study, 41 were identified as high risk. None of them developed a pressure-related injury.” The article goes on to say “The unit has demonstrated excellent outcomes. PUs are no longer seen as inevitable, and rather than requiring very ‘high-tech’ interventions, the simple prophylactic application of a dressing in conjunction with other PU prevention strategies can contribute to their prevention on the sacral and heel areas.” Wow! This is the type of facility that I want to be a part of.

1 comment:

  1. Great article!! I could not agree more, I think with proper care, especially in long term care facilities most pressure ulcers can be prevented. I personally do not understand why so many in long term care can have these kind of injuries and not have an ethics committee or patient advocate that raises cain about the conditions. That fact that they can be prevented by simple measures with the care team being diligent shows great promise and hopefully we will start to see a decrease in these preventable injuries!!
    Thank you for bringing to light this issue we have all seen in our clinical settings- we in the medical field need to be talking about this and finding ways to prevent pressure ulcers.

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