The quality of healthcare services and the possibility to reach positive health outcomes depend greatly on various dimensions, and pressure ulcer rates are among them. They are defined as “localized injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure alone or in combination with shear” (Qaseem, Mir, Starkey, & Denberg, 2015, p. 359). This issue is often faced by individuals with limited mobility because they spend a lot of time in hospitals and have no possibility to move as needed. Professionals indicate that this problem is not rare and almost 3 million people in the USA suffer from it.
What is more critical, during the last decade of the 20th century, they were reported to cause the death of more than 110,000 individuals. In addition to that, about 21,000 deaths were connected with this problem indirectly. Such data makes professionals realize the severity of the situation and implement various initiatives to improve the situation. The purpose of this paper is to present a proposal for evidence-based practice (EBP) project about the prevention of hospital-acquired pressure ulcer incidence rate during their hospital stay, discussing the influence of the Braden and Waterlow scale that can be used to predict pressure ulcers, compared to clinical judgment alone, on the basis of the adult population.
Background
Pressure ulcers were always considered to be a problem that affects people’s health adversely. Still, it turned into a part of the nursing assessment only 30 years ago. Mainly professionals are encouraged to pay more attention to those patients who spend much time in healthcare facilities because they move less than those who are discharged and sent home. The evidence proves that only 13% of all cases happen during a short stay, while more than 40% of the patients from a long stay unit suffer from pressure ulcers (Gill, 2015). Of course, the majority of these individuals are the elderly because they tend to have more problems with motion. Still, all adults can be at risk depending on their disease and required treatment. To prevent adverse complications, nurses are encouraged to work with the patients thoroughly to predict pressure ulcers (He, Staggs, Bergquist-Beringer, & Dunton, 2016). Initially, they referred only to their clinical judgment, but soon professionals realized that it is not enough and started utilizing additional approaches. For example, Guy (2012) is sure that such risk assessment tools, such as the Braden and Waterlow scale, can benefit nurses and their patients through better risk identification.
Clinical Significance
This topic is important to healthcare because it is meant to ensure the improvement of the patient’s condition, and a high rate of hospital acquire pressure ulcer incidence interfere with this process (Lachenbruch, Ribble, Emmons, & VanGilder, 2016). Patient’s comfort is affected as they have no opportunity to move regardless of the fact that it is needed. What is more, people’s state can become worse while being in a hospital, which proves that the quality of patient care is not good enough? Professionals need to develop new guidelines and to improve the situation so that healthcare facilities treat and cure people instead of worsening their condition (Tayyib & Coyer, 2016). As a result, the overall health of the population can also be enhanced.
Purpose
The purpose of the paper is to find the answer the question: in adult patients, how does the Braden and Waterlow scale used to predict pressure ulcers, compared to clinical judgment alone, influence hospital acquire pressure ulcer incidence rate during their hospital stay. Thus, such aspects of the projects in PICOT format should be considered:
- Population – adult patients;
- Interest – the Braden and Waterlow scale;
- Control – clinical judgment;
- Outcome – hospital acquire pressure ulcer incidence rate;
- Timeline – the hospital stay.
References
Gill, E. (2015). Reducing hospital acquired pressure ulcers in intensive care. BMJ Quality Improvement Reports, 4(1), u205599-w3015.
Guy, H. (2012). Pressure ulcer risk assessment. Nursing Times, 108(4), 16-20.
He, J., Staggs, V., Bergquist-Beringer, S., & Dunton, N. (2016). Nurse staffing and patient outcomes: A longitudinal study on trend and seasonality. BMC Nursing, 14(15), 60.
Lachenbruch, C., Ribble, D., Emmons, K., & VanGilder, C. (2016). Pressure ulcer risk in the incontinent patient: Analysis of incontinence and hospital-acquired pressure ulcers from the international pressure ulcer prevalence™ survey. Journal of Wound Ostomy & Continence Nursing, 43(3), 235-41.
Qaseem, A., Mir, T., Starkey, M., & Denberg, T. (2015). Risk assessment and prevention of pressure ulcers: A clinical practice guideline from the American college of physicians. Annals of Internal Medicine, 162, 359-369.
Tayyib, N., & Coyer, F. (2016). Effectiveness of pressure ulcer prevention strategies for adult patients in intensive care units: A systematic review. Worldviews on Evidence-Based Nursing, 1, 1-13.