The risk of developing pressure ulcers in ICU patients is a rather severe problem; nevertheless, nurses and doctors regularly face it. In order to prevent it, it is necessary to determine what the cause of the development of pressure ulcers is, as well as pay attention to the complications that this ailment causes. PICOT question, developed on the basis of the information studied, can help to achieve success in the treatment and prevention of pressure ulcers.
Pressure ulcers are a pathological change in the skin, muscles, and other tissues of the body. According to Sullivan and Schoelles (2013), such a change develops in the type of neurotrophic disorder. Its main causes are a violation of the blood circulation of the body’s specific part when a long-term contract with a hard surface produces dangerous changes in the skin. The development of pressure ulcers on the body complicates the treatment of patients in the intensive care unit and requires increased attention from the staff of the clinic.
Pressure ulcers develop quickly in depleted patients who also have problems with the cardiovascular system. The most typical lesions are the protruding parts of the body: heels, scapula, sacrum, cervical vertebrae. An extended stay of a sedentary patient on a hard surface is the most frequent reason for the appearance of neoplasms on the body. The larger a pressure ulcer is, the more difficult it will be to get rid of it. Possible consequences are gangrene, sepsis, or tissue necrosis.
In the damaged area, there is a loss of sensitivity or tingling caused by the stagnation of blood and other biological fluids. The skin is colored in a dark color because of the accumulation of peripheral blood and lymph. Quite often, purulent blisters are formed. The most vulnerable to this problem are the elderly who often cannot move independently and are forced to spend much time motionlessly.
Pressure ulcers refer to those pathologies that are essential to avoid beforehand. Otherwise, the treatment will be very long, and various pathologies can develop. For example, amputation of the lower extremities, significant damage to bone tissue, extensive defects in soft tissues, and the exhaustion of body forces are dangerous complications that lead to pressure ulcers. As Swafford, Culpepper, and Dunn (2016) remark, if timely measures are not taken, the patient will experience pain and will not be able to recover quickly. Therefore, significant attention should be paid to the prevention of pressure ulcers.
The diagnosis of pressure ulcers in patients is carried out by considering four possible stages. In the first step, there is slight damage to the skin. The second and third stages are characterized by more significant tissue injuries. In the last phase, cells are on the verge of extinction, and the problem is very severe. It is essential to identify the symptoms of the disease timely and take appropriate preventive measures, for example, to change bed linen regularly and rub the areas of the body that are under the potential threat.
Thus, pressure ulcers are a dangerous and serious problem that ICU patients can experience. To avoid it, it is possible to take preventive measures and control the state of the body tissues regularly. As likely research, the following PICOT question can be asked: 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)?
Sullivan, N., & Schoelles, K. M. (2013). Preventing in-facility pressure ulcers as a patient safety strategy: A systematic review. Annals of Internal Medicine, 158(5), 410-416.
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.