Pressure Ulcers Essay

1984 words - 8 pages

Evidence Based Practice & Pressure Ulcers
Matthew Slawter
Chamberlain College of Nursing
NR451 RN Capstone Course
November 2014

Evidence Based Practice & Pressure Ulcers
Evidence based practice (EBP) gives nurses a method to use critical appraised data and scientific evidence that is proven to confirm the delivery of quality health care to a patient population. Pressure ulcer prevention continues to be a major and growing concern among todays patients and healthcare providers. This problem is a concern because prevention of pressure ulcers can be accomplished through good skincare techniques and increased education of nurses. The field of nursing along with the healthcare ...view middle of the document...

The relative intervention is to ensure frequent patient repositioning and the use of the Braden scale while being compared to no structural repositioning technique and no use of the Braden scale. Thus, the expected outcome is that there is prevention of skin breakdown relating to pressure ulcers during hospitalizations for patients.
Step 2: Scope of practice question
Pressure ulcers are a problem and can lead to poor patient outcomes as well as hospital fines. Evidence based studies have shown that “the average cost of care in an acute care hospital for a patient with a stage III or stage IV pressure ulcer reported by the Centers for Medicare & Medicaid Services (CMS) is $43,180” (Jackson, 2008). Pressure ulcers and other skin breakdowns are among the most significant adverse events causing distress for patients and their care givers and compromising patients’ recovery from illness or injury (Gardiner, 2008). It is the tasks of nurses to ensure prevention of these complications is part of the daily care regimen.
Steps 3, 4, and 5: Team
An interdisciplinary team of professional staff is a necessity to overcome the issue of pressure ulcer development among patients. Relevant stakeholders would include a nurse, nurse aide, dietitian, and a hospitalist. The primary responsibilities of the nurse consist of completing and documenting skin and risk assessments, monitor progress and/or changes in medical/skin conditions, report patient problems to the hospitalist, and work with the wound team to prevent and treat pressure ulcers. The nurse aide is responsible for examining skin during each position change and skin cleaning, performing appropriate care plan tasks, and report task completion and skin issues to the nurse. A dietitian is responsible for assessing the patient’s status relating to diet and making patient specific dietary recommendations which include supplements. While the mentioned members hold significant responsibilities, the hospitalist is responsible for reviewing the rehabilitation therapy needed along with ordering interventions that are specific to the patient’s need. Each member is chosen due to the importance of reversing the related issues in regards to pressure ulcers.
Steps 6 and 7: Internal and external search for evidence
EBP shows that the adoption of the Braden scale was to ensure the assessment of risks to skin integrity is practiced along with placing preventative care practices. The Braden scale assists clinicians with identifying patients at risk for skin issues upon the initial assessment of a patient. EBP also shows that in some studies, “skin integrity risks are identified at the time of initial assessment increased from 16.5% to 44.6%” (Gardiner, 2008). It is when risks are identified that imperative actions in terms of interventions will minimize the risk of pressure ulcer development. Recent research has shown that skin-cleansing products, emollients, foams, and creams perform...

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