The modern healthcare sector is focused on the gradual reconsideration of all services it provides to patients with the primary aim to significantly improve the health of the nation and eliminate various health concerns threatening citizens living in different states. At the same time, there are numerous efforts to improve the hospital environment to ensure that patients will be able to acquire the needed care and remain protected from negative impacts, pathogens, microorganisms, and bacteria that could be found in their traditional environments.
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Unfortunately, complete elimination of all negative factors is impossible; however, there is the need to reconsider the perspective on aspects that significantly deteriorate treatment results and the quality of patients lives. Pressure ulcers belong to this very category. For this reason, the following research questions are suggested to improve the understanding of the issue and ensure its in-depth analysis:
- What are the anatomical, physiological, and economical issues involved regarding the problem of pressure ulcers in patients of emergency departments?
- What are the statistical facts related to pressure ulcers and their management in the modern healthcare sector?
The fact is that the risk of pressure ulcers development in bed-bound patients of emergency departments is extremely high. The lack of mobility and the long recovery period contribute to the emergence of certain problems with skin covering (Bhattacharya & Mishra, 2015). By the existing statistics, pressure ulcers occur in 23% of patients in long-term rehabilitation facilities, and up to 40% in ICU patients (Ning, Ren, Fan, & Zhang, 2017).
It means that about 60.000 individuals suffer from pressure ulcers annually (Ning et al., 2017). The scope of the problem evidences the necessity to introduce immediate actions to improve the situation in the sphere and attain a significant reduction in the number of cases. In such a way, the central aim of the research is to find an efficient solution to eliminate pressure ulcers in patients of the emergency departments by using specific intervention techniques.
Anatomical, Physiological, and Economical Issues
There are multiple definitions of the problem. The most common one states that pressure ulcers are a specific type of injury characterized by the skin and underlying tissues destructions in particular areas that have been experiencing continuous pressure for a certain period (Bhattacharya & Mishra, 2015). Anatomically, a patient who has pressure sores, or hospital-acquired pressure ulcers (HAPUs), might suffer from pain, bleeding, uncomfortable feelings (Bhattacharya & Mishra, 2015). If left untreated, the problem will result in the development of necrosis and damage to other tissues. For this reason, all patients of emergency departments who demonstrate the first signs of HAPUs evolution should be provided with immediate assistance to avoid the development of numerous complications.
Physiologically, pressure ulcers occur because of several factors. First of all, the continuous pressure results in the emergence of tissue ischemia (Bhattacharya & Mishra, 2015). At the same time, a significant reduction of nutrition and oxygen supply to the tissues caused by the physical impact precondition the development of necrosis (Bhattacharya & Mishra, 2015). In other words, the prolonged application of external force (shear, compression, or both of them) to the same area causes deformation damage and localized ischemic damage to tissues and precondition the occurrence of pressure ulcers (Bhattacharya & Mishra, 2015).
Regarding the character of the factors preconditioning the appearance of this undesired state or complication, the intervention that can help to avoid problems includes replacement of patients, and alteration of their positions to ensure that the external force affects all areas.
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However, if patients have reduced mobility and are not moved, their states become worse and demand specific pharmacological or even surgical interventions to eliminate damaged tissues or ensure their regeneration. It is a costly process that becomes one of the major concerns of the modern healthcare sector. By the latest reports, HAPUs cost the U.S. health system about $9-11 billion per year (Meddingss et al., 2015). This sum includes money spent to treat patients with pressure ulcers, eliminate negative consequences or complications, and improve patients states. In such a way, the economic issue of the problem also becomes a factor impacting the need for its investigation and creation of the solution that will help to improve the situation.
Management of HAPUs
Successful management of pressure ulcers becomes an important aspect that should be considered by all health workers who provide care to patients with limited mobility. It will help to improve treatment outcomes and ensure a significant reduction of sums needed to support the functioning of health facilities as the prevention and in-time provision of the required assistance is much cheaper than the following pharmaceutical or surgical treatment.
It means that one of the possible solutions to the problem is the organization of the environment in which all patients with similar issues are monitored to prevent the occurrence and development of this health issue (Averill, Hughes, Fuller, & Goldfield, 2016). It means the use of innovative equipment and surfaces that help to reduce pressure and replace patients when it is needed.
Statistically, this assumption can be evidenced by the fact that about 40% of all patients in emergency departments might experience reduced mobility or be bed-bound (Averill et al., 2016). It means that almost half of all individuals belong to the group risk characterized by the prolonged impact of a particular external force on the same areas of their skin. Annually, 60,000 patients die from HAPUs and complications associated with them (Meddingss et al., 2015).
Moreover, it remains the second most common hospital billing claim (Kruger, Pires, Ngann, Sterling, & Rubayi, 2013). In other words, the introduction of an efficient solution will help to radically improve the situation and achieve positive results.
At the same time, efficient pressure ulcer management remains the most appropriate method to prevent the development of undesired situations in people. It means that the solution to the problem will affect health workers who provide care in emergency departments. The additional training to improve their understanding of the issue and the introduction of specific innovative devices needed to monitor patients state and signalize the necessity to replace their position will cost much lower if to compare with the annual losses the healthcare sector experiences because of HAPUs and their consequences (Averill et al., 2016). That is why it becomes critical to collect all statistical data about the problem and use it to prove the need for the recommended intervention and its beneficial character.
Altogether, pressure ulcers are one of the major concerns of the modern healthcare sector. Statistics evidence that about 23% of all patients face a risk of acquiring HAPUs because of the reduced mobility and the prolonged impact of external force on their tissues. The scope of the problem can also be evidenced by the fact that $11 billion is spent every year to help individuals suffering from this problem and improve the quality of their lives.
Finally, pressure ulcers might directly impact treatment outcomes because they complicate the work of specialists and demand specific care to patients. For this reason, the intervention aimed at the improvement of the situation regarding this aspect becomes central for the modern healthcare sector. It will help to significantly reduce the number of patients with this concern and save costs that can be devoted to other important issues. Further investigation of the HAPUs will help to find the most appropriate solution to the problem.
Averill, R., Hughes, J., Fuller, R., & Goldfield, N. (2016). Quality improvement initiatives need rigorous evaluation: The case of pressure ulcers. American Journal of Medical Quality, 32(5), 552-555. Web.
Bhattacharya, S., & Mishra, R. (2015). Pressure ulcers: Current understanding and newer modalities of treatment. Indian Journal of Plastic Surgery, 48(1), 4-16. Web.
Kruger, E., Pires, M., Ngann, Y., Sterling, M., & Rubayi, S. (2013). Comprehensive management of pressure ulcers in spinal cord injury: Current concepts and future trends. The Journal of Spinal Cord Medicine, 36(6), 572-585. Web.
Meddingss, J., Reichert, H., Rogers, M., Hofer, T., McMahon, M., & Grazier, K. (2015). Under pressure: Financial impact of the hospital-acquired conditions initiative. A statewide analysis of pressure ulcer development and payment. Journal of the American Geriatrics Society, 63(7), 1407-1412. Web.
Ning, M., Ren, M., Fan, Q., & Zhang, L. (2017). Mechanism design of a robotic chair/bed system for bedridden aged. Advances in Mechanical Engineering, 9(3), 1-8. Web.