The risk of developing pressure ulcers both in intensive care units and in usual hospital settings predetermined the need to find solutions to this nursing problem. The possibilities of modern medicine make it possible to competently approach the struggle against ulcers, and in many hospitals, new modern protocols have been used to reduce the risk of such an ailment. It is essential to identify all the factors that can affect the development of pressure ulcers, mention the epidemiology and diagnosis of this disease, and also offer the PICOT question as a possible intervention.
Pressure ulcers are damages to the skin that result from prolonged compression of the tissues. Most such damages occur on those areas of the skin that are located above the bony protuberances: knees, elbows, hips, buttocks, and the rump. In this regard, these zones of the body should be reliably protected in order to prevent the deformation of the skin and blood stagnation.
Checking the skin condition should become a routine part of the nursing care process both at home and in the hospital. In addition to constant pressure, friction can also contribute to the formation of pressure ulcers. According to Qaseem, Humphrey, Forciea, Starkey, and Denberg (2015), any person with limited mobility is at risk of having such a problem, and the need to find an appropriate solution to the issue is quite relevant and acute. Moreover, many methods of struggle that are known today do not have a proper effect. Therefore, effective measures should be taken.
The development of pressure ulcers always takes place in four stages. At the initial stage, the consequences of injuries are not too significant. At the second phase, the ulcer looks like an open wound. At the third stage, a deep wound occurs. Finally, the fourth phase is characterized by extensive necrosis of damaged tissues. Those patients who are in a sitting position most often suffer from pressure ulcers in the areas of the sacrum, buttocks, scapula, and spine. In bedridden patients, in addition to these areas of the body, the neck, hips, heels, and knees also suffer.
In the course of treatment of pressure ulcers, specialists can face some difficulties. For example, as Miller, Frankenfield, Lehman, Maguire, and Schirm (2016) note, one of the complications is excess weight, which greatly accelerates the process of producing ulcers because of excessive pressure on the tissue. Also, damaged areas of the skin can cause subsequent complications in the form of gangrene, skin cancer or sepsis. Therefore, timely diagnosis and treatment are very important.
It is essential to determine the degree of pressure ulcers development and prevent further spread of the disease. According to Swafford, Culpepper, and Dunn (2016), one of the methods used as a rather effective technique of identifying and dealing with the problem is to use a special skin care protocol aimed at stopping the development of the infection. Also, it should be noted that the more effective preventive measures are, the lower the risk of ulcers is. The diagnosis at an early stage will greatly simplify the treatment process and help to faster cope with the disease.
Thus, specific measures aimed at combating the spread of pressure ulcers can be useful if the disease is identified at an early stage. As a solution to the problem, it is possible to propose a certain PICOT question. It is as follows: 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)?
Miller, N., Frankenfield, D., Lehman, E., Maguire, M., & Schirm, V. (2016). Predicting pressure ulcer development in clinical practice: Evaluation of Braden Scale Scores and nutrition parameters. Journal of Wound Ostomy & Continence Nursing, 43(2), 133-139.
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.
Qaseem, A., Humphrey, L. L., Forciea, M. A., Starkey, M., & Denberg, T. D. (2015). Treatment of pressure ulcers: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 162(5), 370-379.