Challenges caused by pressure ulcers in the article pressure ulcer intervention

Army as a combat medic and nurse for over six years and recently worked as the Community Relations Director for a health center.

Challenges caused by pressure ulcers in the article pressure ulcer intervention

Introduction Pressure ulcer treatment is one of many aspects of patient care in which nursing care interfaces directly with clinician-provided medical services.

Challenges caused by pressure ulcers in the article pressure ulcer intervention

Traditionally, the treatment of pressure ulcers has been left to nurses. Realization of the costs associated with the treatment of pressure ulcers and recent requirements by third-party payers have prompted physicians to become more actively engaged in the prevention, identification, and treatment of pressure ulcers.

Pressure ulcers are localized areas of tissue damage or necrosis that develop because of pressure over a bony prominence. They have previously been called pressure sores, bedsores, and decubitus ulcers, terms that imply that only bed-bound, nonambulatory patients develop pressure ulcers.

It is important to recognize that patients who are ambulatory can also develop pressure ulcers, although reduced mobility is still a major risk factor. The purpose of this article is to familiarize physicians and other clinicians who provide care to hospitalized patients, such as physician assistants, certified nurse midwives, and nurse practitioners, with some of the terminology associated with pressure ulcers, so that they can better assess patients at risk for the development of pressure ulcers and properly identify and describe pressure ulcers.

Costs For a sense of the total costs of the treatment of pressure ulcers, data from the s, although old, can shed a light on current costs. In Novemberthe Center for Medicare and Medicaid Services instituted a policy to withhold reimbursement due to be made to acute-care hospitals for the costs of treating hospital-acquired conditions, 6 such as pressure ulcers.

Although hospitals will be paid for the care of pressure ulcers that originated before admission, hospital-acquired pressure ulcers would be the responsibility of the admitting hospital.

Because of this change in policy, there is now an incentive for hospitals to accurately assess for skin problems in all patients being admitted and to identify all patients at risk for developing pressure ulcers so that preventive measures can be put in place.

Increasingly physicians are being called on to identify at-risk patients and accurately classify skin conditions present at admission. Identification and Risk Assessment On admission to an acute-care hospital, all patients should undergo a thorough skin assessment to determine if they are being admitted with skin conditions, including pressure ulcers, that were already present.

Any such condition must be clearly documented on the record of the admission physical examination.

Pressure Ulcer Prevention

This documentation is ultimately the responsibility of the admitting physician. In addition to performing a complete skin assessment, it is also important to identify the patient who may be at risk for developing a pressure ulcer after admission to the hospital.

Such identification should then initiate interventions intended to maintain skin integrity and prevent skin breakdown. The most common assessment tool used for this purpose is the Braden scale, 7, 8 which evaluates the severity of several different factors that would place the patient at risk for the development of a pressure ulcer: Each of these factors is ranked on a numeric scale from 1 to 4, with the exception of friction and shear, which only has three points on its scale.

Scores are then totaled. Ultimate risk is determined by the total Braden score, with the highest possible score being Patients with scores of 18 or less are considered to be at varying degrees of risk.what are pressure ulcers caused by? - unrelieved pressure applied w/ great force over a shirt period of time disrupting blood flow depriving tissues of oxygen and nutrients name some common sites for pressure ulcers.

The European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel have recently published a joint report on guidelines for treatment of pressure ulcers.9 Recommendations related to each of these principles are provided in that report, which can be accessed at Pressure ulcers are defined as an area of localised damage to the skin and/or underlying tissue as a result of pressure or pressure and shear (National Pressure Ulcer Advisory Panel et al., ).

T1 - Challenges in pressure ulcer prevention. AU - Dealey,Carol. AU - Brindle,C.

Patient Safety and Quality: An Evidence-Based Handbook for Nurses.

Tod. AU - Black,Joyce. AU - Alves,Paulo. AU - Santamaria,Nick.

Challenges caused by pressure ulcers in the article pressure ulcer intervention

AU - Call,Evan. AU - Clark,Michael. PY - /6/1. Y1 - /6/1. N2 - Although this article is a stand-alone article, it sets the scene for later articles in this issue. The United States has seen an increase in management of pressure ulcers in extended care.

The experiences of an expert wound care nurse providing consultation in an extended care facility are described. As a result of this consultation and implementation of protocols, pressure ulcer prevalence rate decreased from 12% to 4%.

Pressure ulcers are localized injury to the skin and/or underlying tissue usually over a bony prominence as a result of pressure, or pressure in combination with shear (NPUAP, ). Pressure ulcers are staged I through IV according to the amount of observable damage.

Pressure Ulcers: What Clinicians Need to Know