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Management of Pressure Ulcers: Using Protocols as the Key Strategy

Background and Key Objectives: Pressure Ulcers and Protocols

  • Pressure ulcers (PUs): common occurrence in inpatients;
  • PUs management: essential task for any hospital nurse;
  • Cost of care for PUs: excessively high because of health complications;
  • Mitigation of the risk of PUs development as the current priority;
  • Patient safety levels: current health concern in hospitals.

Research Questions: What the Study Seeks to Explore

  • Handling the problem of PUs as a complex process;
  • Necessity to take a vast array of factors into consideration;
  • Can PU protocols prevent the development of PUs?
  • How high are the expenses of using PUs in the hospital setting?
  • Is the use of PU protocols an efficient strategy against PUs?
  • What crucial obstacles must be overcome in using PU protocols?

Problem Statement: Shedding Light on the Issue

  • Emergency departments: increased level of PU development risk;
  • Populations affected extensively by PUs: hospitalized patients;
  • Key problem: absence of a coherent and effective strategy against PUs development;
  • PU protocols as one of the possible prevention tools;
  • Hence the need to test the impact of PU protocols’ use in a hospital setting.

Hypothesis: Determining a Possible Solution to PUs

  • PUs as a more efficient approach that institutionalized care for PUs management;
  • PU protocols as the means of avoiding, managing, and preventing PUs;
  • Close connection between the frequency of preventive care and positive patient outcomes;
  • Variables: preventive care tools (independent); patient outcomes (dependent);
  • Tests: comparison of pre- and post-utilization information about patients’ well-being.

Literature Review: Traditional Methods of PUs Prevention

  • Silicone foam dressing as one of the most common tools for PUs management;
  • Traditional protocol: repositioning of soft padding for the management of PUs;
  • 42.9% effectiveness in application of silicone foam for managing 42.9% (Truong, Grigson, Patel, & Liu, 2016);
  • Lower net costs for silicone foam casts compared to other tools;
  • Problems: length of implementation.

Literature Review: Financial Feasibility of PU Protocols

  • Changes to standard protocols and tools for managing Pus in patients (Cano et al., 2015);
  • Hill-Rom Advanced Microclimate Technology Mattresses as the key material (Cano et al., 2015);
  • Following drop in the development of Pus in the hospital setting;
  • Advantages: relative cheapness and high efficiency (Swafford, Culpepper, & Dunn, 2016);
  • Problem: lack of research regarding traditional and innovative protocols.

Literature Review: Barriers in Establishing Protocol-Based PU Management

  • PUs prevention: necessity to locate obstacles and strategies for their management (Worsley, Clarkson, Bader, & Schoonhoven, 2016);
  • PUs prevention problems: recent drop in nurse education quality;
  • PUs prevention concerns: professional boundaries limiting nurses’ actions;
  • PUs management techniques: focus on avoiding the problem.

Research Methods: Essential Information

  • Research design: adoption of the mixed method as the most effective one;
  • Target demographic; 40 immobile patients with the propensity toward PUs (Liu, Moody, Traynor, Dyson, & Gall, 2014);
  • Two groups: control group (traditional tools) and intervention groups (protocols) (Clark et al., 2014);
  • Qualitative interview: strategy for determining barriers to effective practice;
  • Thematic analysis as the basis for conducting qualitative research (Cano et al., 2015).

Research Results Discussion and Analysis of the Findings

  • Participants experiencing high risks of developing PUs;
  • Mobility subscale as the key measurement tool for determining the threat of PUs (ProHealth Wound Care, n.d.);
  • Effectiveness of the intervention: standardized PU classification scale;
  • Intervention outcomes: stage 1 PU in 20% of patients; stage 2 in 10% of patients;
  • Control group: twice as high levels of PUs development.

Conclusion: Implications for Further Research

  • Limitations: comparatively low number of participants;
  • Research outcomes: initial hypothesis confirmed;
  • Necessity for developing a comprehensive PUs management framework;
  • Positive effects of hospital managers on PUs prevention;
  • Patient education as one of the crucial steps toward PUs prevention.


Cano, A., Anglade, D., Stamp, H., Joaquin, F., Lopez, J. A., Lupe, L., … Young, D. L. (2015). Improving outcomes by implementing a pressure ulcer prevention program (PUPP): Going beyond the basics. Healthcare, 3(3), 574–585.

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Clark, M., Black, J., Alves, P., Brindle, C. T., Call, E., Dealey, C., & Santamaria, N. (2014). Systematic review of the use of prophylactic dressings in the prevention of pressure ulcers. International Wound Journal, 11(5), 460-471.

Liu, L. Q., Moody, J., Traynor, M., Dyson, S., & Gall, A. (2014). A systematic review of electrical stimulation for pressure ulcer prevention and treatment in people with spinal cord injuries. The Journal of Spinal Cord Medicine, 37(6), 703-718.

ProHealth Wound Care. (n.d.). Risk for pressure ulcers [Image]. Web.

Swafford, K., Culpepper, R., & Dunn, C. (2016). Use of a comprehensive program to reduce the incidence of hospital-acquired pressure ulcers in an intensive care unit. American Journal of Critical Care, 25(2), 152-155.

Truong, B., Grigson, E., Patel, M., & Liu, X. (2016). Pressure ulcer prevention in the hospital setting using silicone foam dressings. Cureus, 8(8), e730. Web.

Worsley, P. R., Clarkson, P., Bader, D. L., & Schoonhoven, L. (2016). Identifying barriers and facilitators to participation in pressure ulcer prevention in allied healthcare professionals: A mixed methods evaluation. Physiotherapy, 103(3), 304-310.

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