Healthcare workers do their best to save lives and improve the health of their patients. However, in the course of staying at a hospital, a person that remains immobile for a long time can develop pressure ulcers ― injuries that cause skin damage due to the prolonged pressure on some parts of the body and, consequently, skin. The present paper discusses the definition, epidemiology, clinical presentation, complications, and diagnosis of bedsores. In the conclusion, the PICOT question for further research is presented.
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The most comprehensive explanation of pressure ulcers is given by the National Pressure Ulcer Advisory Panel. Bedsores are defined as a “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” (as cited in Mallah, Nassar, & Kurdahi Badr, 2015, p. 106). This condition has high morbidity and mortality rates, and it involves high care costs.
Epidemiology of pressure ulcers is crucial in explaining the burden of the disease and the efforts aimed at enhancing care. According to Berlowitz (2014), the epidemiology of bedsores involves the analysis of the distribution and frequency of the illness. Berlowitz (2014) remarks that the most common understanding of pressure ulcer epidemiology is concerned with their constituting one of the most widespread conditions occurring in nursing practice. Prevalence rates in different types of intensive care units vary between 15% and 20% (Berlowitz, 2014). Incidence requires two evaluations ― at the baseline and in a few days of hospital stay to assess the development.
Clinical presentation of pressure ulcers is manifested through four different stages. Stage 1 is a “non-branch able erythema” that involves “non-branch able redness of a localized area (Kottner & Raeder, 2014, p. 50). This phase may be hard to identify in dark-skinned patients. Stage 2 is called “partial thickness,” and it is manifested through a shallow open ulcer with a pink or red would bed (Kottner & Raeder, 2014, p. 50). Stage 3 is defined as “full-thickness skin loss” (Kottner & Raeder, 2014, p. 50). Finally, stage 4 is “full-thickness tissue loss,” and it may include tunneling and undermining (Kottner & Raeder, 2014, p. 51).
Bedsores may lead to serious complications, such as cellulitis or bone and joint infections. Less frequently, cancer or sepsis can develop from long-term pressure ulcers (“Bedsores (pressure ulcers),” n.d.). Joint infections can damage the patient’s tissue and cartilage, while bone infections can eliminate the function of limbs and joints (“Bedsores (pressure ulcers),” n.d.). Individuals with long-term wounds can develop squamous cell carcinoma (“Bedsores (pressure ulcers),” n.d.).
To diagnose bedsores, a physician needs to examine the patient’s skin thoroughly. If any unusual signs are noticed, the doctor will try to determine the nature of these alterations. In case pressure ulcers are diagnosed, it is necessary to identify the stage of the disease (“Bedsores (pressure ulcers),” n.d.). Staging helps to determine the best treatment option for the patient. A general blood test may also be required to assess the patient’s health.
Pressure ulcers constitute a serious health condition that can occur in patients that remain immobile for a long time. To prevent the development of bedsores, a thorough examination of such patients should be performed regularly. One of the possible ways of relieving pressure ulcer incidence is the implementation of special protocols. The PICOT question is: in patients that are identified as high risk for developing a pressure ulcer (P), does the implementation of a pressure ulcer protocol initiated in the emergency department (I) as compared to patients who receive usual care (C), reduce the incidence of hospital-acquired pressure ulcers (O) on day 3 of hospitalization (T)?
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Bedsores (pressure ulcers). (n.d.). Web.
Berlowitz, D. (2014). Incidence and prevalence of pressure ulcers. In D. R. Thomas & G. A. Compton (Eds.), Pressure ulcers in the aging population: A guide for clinicians (pp. 19-26). New York, NY: Humana Press.
Kottner, J., & Raeder, K. (2014). Assessment and documentation of pressure ulcers. In D. R. Thomas & G. A. Compton (Eds.), Pressure ulcers in the aging population: A guide for clinicians (pp. 47-65). New York, NY: Humana Press.
Mallah, Z., Nassar, N., & Kurdahi Badr, L. (2015). The effectiveness of a pressure ulcer intervention program on the prevalence of hospital acquired pressure ulcers: Controlled before and after study. Applied Nursing Research, 28(2), 106-113.