Introduction
A high incidence level of pressure ulcer development in bedridden patients presents a severe concern for health care professionals. Hazardous complications that hospital-acquired tissue injuries might cause encourage clinicians to address the issue with precision and awareness to prevent adverse outcomes for hospitalized patients. The information about epidemiology, as well as the diagnostic approaches and pressure ulcer protocol implementation, provide multiple opportunities to minimize the incidence of tissue injuries.
Definition
Clinicians use different terminology to define the analyzed issue, including pressure ulcers, pressure sore, or injury. According to Becker et al. (2017), it is described as “damage of the skin or underlying tissue, usually over a bony prominence, as a result of pressure, alone or combined with shear” (p. 56). Such traumas are acquired due to the pressure of the body against the surface upon a long-term immobile position. The reasons for pressure ulcer development vary from muscle weaknesses to devise procedure implementation.
Epidemiology
The incidence of pressure sores is at a high level of occurrence among bedridden patients. Pressure ulcer rates measuring, incidence and prevalence allow making conclusions about the epidemiology of pressure ulcers (Berlowitz, 2014). The incidence rates of bedsores development in intensive unite care patients vary between 8.8% and 25.1% (Becker et al., 2017). According to Berlowitz (2014), approximately 14% of high-risk patients developed ulcers upon the first hospitalization, and about 36% of those hospitalized for the second time acquired pressure sores. Therefore, the issue is widespread and requires precise attention from health care professionals.
Clinical Presentation
Pressure injuries acquisition depends on the duration of hospital stay and starts soon after the placement of a patient in a care unit. There are several stages of ulcer development that are characterized by different features. The first stage is characterized by skin redness; the second involves visible skin damage that increases during the third and fourth stages. During the final phases of ulcer development there occur muscle injury and destruction (Black, Brindle, & Honaker, 2016). These symptoms cause discomfort, pain, and possible complications for patients.
Complications
The uncured pressure ulcers might lead to multiple problems with health depending on the severity of the tissue injuries. The most frequently recognized complications related to ulcers are “depression, loss of function, dependency, infection, sepsis, additional surgical interventions” (Becker et al., 2017, p. 56). The complications might lead to a prolonged hospitalization endangering a patient to develop more ulcers. Therefore, it is vitally important to establish a timely diagnosis of the issue and prevent the development of pressure ulcers from the very beginning of a patient’s stay at a hospital.
Diagnosis
The nursing staff needs to utilize appropriate knowledge, skills, and materials to implement proper, timely diagnosis of pressure sores to prevent their emergence and protect patients from adverse outcomes and health complications. It is vital to assess the risk factors for a particular patient and develop a plan of examinations of the skin to ensure an accurate diagnosis of the problem. This process involves an “initial skin assessment on admission” and detection of erythema around an identified ulcer (Black et al., 2016, p. 538). The clinicians have to use particular protocols to provide a quality diagnosis of bedsores.
Conclusion with PICOT Question
In summary, pressure ulcers are a severe health issue that is caused by the immobility of a patient, and in the case of improper treatment or delayed detection might lead to complications. Professional nurses have to incorporate risk rates, initial condition, and the particularities of a patient’s hospitalization procedures to ensure high-quality care. The discussion allows stating a PICOT question: 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)?
References
Becker, D., Tozo, T. C., Batista, S. S., Mattos, A. L., Silva M. C. B., Rigon, S., … Duarte, P. (2017). Pressure ulcers in ICU patients: Incidence and clinical and epidemiological features: A multicenter study in southern Brazil. Intensive and Critical Care Nursing, 43, 55-61.
Berlowitz, D. (2014). Incidence and prevalence of pressure ulcers. In D. R. Thomas & G. A. Compton (Eds.), Pressure ulcers in the aging population: A guide for clinicians (pp. 19-26). New York, NY: Humana Press.
Black, J. M., Brindle, C. T., & Honaker, J. S. (2016). Differential diagnosis of suspected deep tissue injury. International Wound Journal, 13, 531-539.