Introduction
Nursing personnel faces many difficulties when working in intensive care units (ICUs). Despite the experience of employees, some of the challenges are hard to avoid, which forces the staff to resort to additional methods of providing care for those patients who cannot satisfy their daily needs independently. One of these difficulties is pressure ulcers that are formed due to a long stay in the supine position. They bring discomfort to both the junior medical personnel and patients, and the search for relevant methods to combat this issue is an essential task.
In order to find appropriate solutions to the problem of pressure ulcers in patients in ICUs, it is possible to study the appropriate academic literature where this problem is described. Current sources may have important information regarding approaches to preventing the development of this ailment and measures to eliminate it. The purpose of this work is to analyze the methods of researchers’ work concerning difficulties associated with pressure ulcers, as well as to consider the results of the review. For obtaining a comprehensive picture, relevant findings may be referred to as potentially effective interventions. As one of the review mechanisms, such an analysis technique as the PICO question can be applied.
This mechanism makes it possible to identify the key aspects of review and narrow the search spectrum, thereby simplifying the work process. The PICO question for the topic under consideration may be as follows: in those patients with pressure ulcers who undergo treatment in intensive care units (P), how effective is the use of specific preventive measures (I) compared to standard care principles (C) in reducing the consequences of the problem (O)?
Methods
To find solutions to the problem under consideration, researchers use special methods. Behrendt, Ghaznavi, Mahan, Craft, and Siddiqui (2014) conduct a controlled study to identify whether a continuous pressure ulcer mapping device is a valuable technique. The keywords of this research are pressure ulcers, mapping, device, and patients. A corporate database was used to collect data on patients.
The sample did not have any exclusion criteria, and the period was two months. Bly, Schallom, Sona, and Klinkenberg (2016) conduct a chat review for ten months and observe variables related to the issue of pressure ulcers. The keywords are intensive, care, patients, pressure, ulcers, and perfusion. The authors substantiate the need to solve the problem based on the results from The National Database of Nursing Quality Indicators and do not mention any exclusion criteria (Bly et al., 2016, p. 158).
Hyun et al. (2014) apply a data collection technique based on the assessment of variables relevant to the body mass index. A series of keywords are listed in the study – body mass, weight, pressure, ulcers, and patients. No specific databases are mentioned, and there is an exclusion criterion for those patients who are in the medical unit less than three days. Serra et al. (2015) review the information obtained as a result of the assessment of patients with hypoalbuminemia in ICUs, analyzing two target groups of participants. The authors resort to the definition of ulcers mentioned in the NPUAP / EPUAP classification system, and their article has a number of keywords – pressure, ulcers, albumin, and patients (Serra et al., 2015). The inclusion criterion mentioned is a 24-hour stay in ICU.
Smit, Harrison, Letzkus, and Quatrara (2016) conduct a chat review based on demographic statistics. The keywords of their study are pressure, ulcer, age, gender, and weight. No specific databases are mentioned, as well as exclusion criteria. Swafford, Culpepper, and Dunn (2016) develop a program based on staff education. The authors use a common database of patients and consider various cases related to the issue of pressure ulcers (Swafford et al., 2016). The keywords of the study are pressure, ulcer, education, and program.
Results
The results obtained by Behrendt et al. (2014) confirm the effectiveness of the implementation of a continuous bedside pressure mapping device to prevent the development of the disease. The goal of the researchers is to determine how this method of work affects the physical state of the 213 selected participants. The data were compared in two groups, and the outcome of the intervention among the target patients was more positive.
Bly et al. (2016) who review patients in ICUs argue that their model that is applied for the purpose of finding correlations between specific variables and the development of pressure ulcers is relevant. 345 people were selected as the participants of this research, and “the model of pressure, oxygenation, and perfusion” was applied to them to prove the study’s objective (Bly et al., 2016, p. 156). The strength of both works is that many participants were selected, and no significant weaknesses may be mentioned.
The purpose of the study by Hyun et al. (2014) is to determine whether there is a connection between weight and the development of pressure ulcers. The data collected are divided into four categories based on participants’ mass index. Overweight influences pressure ulcers significantly, which demonstrates the strength and relevance of the authors’ hypothesis (Hyun et al., 2014). The intervention performed by Serra (2015) aims at identifying the effect of albumin administration in relation to the problem.
The statistics of 73 patients are analyzed, and the diagnosis of hypoalbuminemia is the key data collection criterion. The findings demonstrate the success of the intervention, and its strength is that medical intervention for the target population has no potential limitations. The only weakness is that not all patients with a propensity for pressure ulcers can participate in such a program.
The goal of the work by Smit et al. (2016) is to determine whether there are demographic factors that affect the problem. According to the findings, the crucial factors that should be taken into account are “the administration of vasopressor support and patient length of stay” (Smit et al., 2016, p. 38). The information is collected among men and women in equal proportions. The weakness of the study is that too many different variables are included in the study.
The only strength is the large number of target group participants. The purpose of the research by Swafford et al. (2016) is to identify how staff education influences the effectiveness of pressure ulcer prevention. Information about patients was collected, and in parallel, staff training was performed. As the author’s remark, personnel education is the successful way of combating the problem considered (Swafford et al., 2016). The strength is the study’s orientation not only on patients but also on medical employees.
Discussion
Based on the results of the assessment, the reviewed academic papers carry useful information regarding the resolution of the pressure ulcer problem in patients in ICUs. This topic is characterized by the fact that different approaches may be applied, and the relevance of interventions is confirmed by the findings. The strength of such studies is significant since the search for solutions can save patients from severe discomfort. Studies on both drug interventions and staff education benefit the topic.
Conclusion
The review of academic articles on the control of pressure ulcers in patients in ICUs suggests that work is needed in this direction. Different variables may be taken into account, and both medical interventions and innovative technologies can be applied. Further work may be related to the search for new techniques based on the modern models of care. Medical personnel should be responsible for the problem and take appropriate actions to protect patients.
References
Behrendt, R., Ghaznavi, A. M., Mahan, M., Craft, S., & Siddiqui, A. (2014). Continuous bedside pressure mapping and rates of hospital-associated pressure ulcers in a medical intensive care unit. American Journal of Critical Care, 23(2), 127-133. Web.
Bly, D., Schallom, M., Sona, C., & Klinkenberg, D. (2016). A model of pressure, oxygenation, and perfusion risk factors for pressure ulcers in the intensive care unit. American Journal of Critical Care, 25(2), 156-164. Web.
Hyun, S., Li, X., Vermillion, B., Newton, C., Fall, M., Kaewprag, P.,… Lenz, E. R. (2014). Body mass index and pressure ulcers: Improved predictability of pressure ulcers in intensive care patients. American Journal of Critical Care, 23(6), 494-501. Web.
Serra, R., Grande, R., Buffone, G., Gallelli, L., Caroleo, S., Tropea, F.,… de Franciscis, S. (2015). Albumin administration prevents the onset of pressure ulcers in intensive care unit patients. International Wound Journal, 12(4), 432-435. Web.
Smit, I., Harrison, L., Letzkus, L., & Quatrara, B. (2016). What factors are associated with the development of pressure ulcers in a medical intensive care unit? Dimensions of Critical Care Nursing, 35(1), 37-41. Web.
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. Web.