Problem
Because nurses participate in all phases of health delivery and are the ones who closely communicate with the patients, they have the most capacity to mitigate preventable injuries. Despite this possibility, unintentional injuries are a significant concern in contemporary nursing. An example of such preventable injuries is pressure ulcers, which come from damages to the skin or underlying tissue (Mervis & Phillips, 2019). While it is certainly possible for anyone to get these pressure sores, it generally affects people who are unable to move freely and are forced to sit or lie for extended periods (Engels et al., 2016). This fact puts more pressure on contemporary nursing practice, as there should be improvements both in clinical practice and education to address the issue of pressure ulcers.
Settings
Pressure ulcers are widespread among people who suffered a spinal injury and are tied to a wheelchair. While these sores are more prevalent among those who are not under constant medical surveillance, there also patients who are in hospitals that experience the same issues (Gardiner et al., 2016). For instance, patients who are unable to move by themselves and are forced to rest in bed may unintentionally receive bedsores because constant lying also provides continued pressure on the skin and tissues.
Problem Description
Pressure ulcers are areas of necrosis and ulceration that occur in places where soft tissue is squeezed between the bony protrusions and hard surfaces. They arise due to pressure combined with friction, displacement forces, and moisture (Bhattacharya & Mishra, 2015). Risk factors include higher age, impaired blood circulation, and tissue perfusion, immobilization, malnutrition, decreased sensitivity, and urinary and fecal incontinence (Demare et al., 2015). The severity of these skin injuries varies, but the most dangerous consequence is the formation of necrosis of soft tissues through the whole skin thickness (Oomens, Bader, Loerakker, & Baaijens, 2015). In the early stages, the damage is manageable, but as the injuries grow, there is a risk of dangerous infections that are difficult to treat. Therapy consists of reducing pressure, eliminating friction and displacement forces, as well as proper wound care. Sometimes, to facilitate healing, transplantation of the skin or muscle flaps is necessary.
Impact
There are cases when patients get bedsores during their stay at hospitals (Bredesen, Bjøro, Gunningberg, & Hofoss, 2015). Not only do these injuries lead to adverse patient outcomes, but they also indicate the low quality of care at those institutions. To mitigate such situations, some health providers develop appropriate strategies and assign special teams (Mervis & Phillips, 2019). Both the environment in which the patients are staying and the employees are working need to be adapted to host and treat people who are more prone to pressure ulcers.
Significance
The possibility that any person may get pressure ulcers even within hospital settings creates space for significant research on the given topic. Nursing practice is most affected by this problem because patient outcomes mainly depend on the quality of care provided by nurses (Aslan & van Giersbergen, 2016). They are the ones who are responsible for giving comprehensive care and applying various preventive mechanisms. The issue directly affects nursing by creating a need for changes in current nursing practices.
Recommendations
Because mostly unintentional injuries cause pressure ulcers, the nursing community should introduce new prevention strategies to mitigate the adverse effects of bedsores. Appropriate education and training are required for nurses to manage patients that are in risk groups appropriately. Health providers should develop adequate strategies and regulations to decrease the number of pressure ulcer cases. With this comprehensive approach, it will be possible to eliminate any possibilities of getting pressure sores.
References
Aslan, A., & van Giersbergen, M. Y. (2016). Nurses’ attitudes towards pressure ulcer prevention in Turkey. Journal of Tissue Viability, 25(1), 66-73.
Bhattacharya, S., & Mishra, R. K. (2015). Pressure ulcers: Current understanding and newer modalities of treatment. Indian Journal of Plastic Surgery, 48(1), 4-16.
Bredesen, I. M., Bjøro, K., Gunningberg, L., & Hofoss, D. (2015). The prevalence, prevention and multilevel variance of pressure ulcers in Norwegian hospitals: A cross-sectional study. International Journal of Nursing Studies, 52(1), 149-156.
Demarre, L., Verhaeghe, S., Van Hecke, A., Clays, E., Grypdonck, M., & Beeckman, D. (2015). Factors predicting the development of pressure ulcers in an at‐risk population who receive standardized preventive care: Secondary analyses of a multicentre randomised controlled trial. Journal of Advanced Nursing, 71(2), 391-403.
Engels, D., Austin, M., McNichol, L., Fencl, J., Gupta, S., & Kazi, H. (2016). Pressure ulcers: Factors contributing to their development in the OR. AORN Journal, 103(3), 271-281.
Gardiner, J. C., Reed, P. L., Bonner, J. D., Haggerty, D. K., & Hale, D. G. (2016). Incidence of hospital‐acquired pressure ulcers – A population‐based cohort study. International Wound Journal, 13(5), 809-820.
Oomens, C. W., Bader, D. L., Loerakker, S., & Baaijens, F. (2015). Pressure induced deep tissue injury explained. Annals of Biomedical Engineering, 43(2), 297-305.
Mervis, J. S., & Phillips, T. J. (2019). Pressure ulcers: Prevention and management. Journal of the American Academy of Dermatology, 81(4), 893-902.