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Pressure Ulcers

Pressure ulcers are common amongst patients who are bed-bound or those receiving medical care via mechanical ventilation. As such, nursing practitioners who are charged with the responsibility of caring for patients with this condition must be well trained on the recently developed and most effective strategies that can be used for pressure ulcer management. This research illustrates why pressure ulcers have become a major problem affecting clients and healthcare institutions and discuss the most effective interventions that can be employed.

Problem Statement

There exists a problem of pressure ulcer development among patients who are on the mechanical ventilator equipment in medical facilities along with bed-bound patients. This problem was chosen for the current research because pressure ulcers have become a major issue that has to be addressed by numerous healthcare institutions in the United States. According to Chou (2013), in 2013, bedsores affected approximately one point three to three million patients. Also, according to Chou (2013), the estimated cost of pressure ulcer treatment is approximately eleven billion dollars.

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As such, these statistics illustrate that pressure ulcers are a critical healthcare problem that requires urgent intervention. The problem will be alleviated by determining the most effective interventions to be employed to improve the patient's condition and reduce the impact of pressure ulcers on such patients. The first intervention that will be analyzed involves the formation of a specialized team that will be responsible for washing as well as repositioning of such specific patients. The second intervention will entail the utilization of a GPS tracking system capable of tracking the periods during which the patients turn and reposition.

Stakeholders

The problem of pressure ulcers can be linked to several national qualities as well as safety indicators. The first is the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), which is also known as the Joint Commission (Joint Commission, 2015). The JCAHO acknowledges that pressure ulcers are a critical problem affecting numerous patients in the United States (Joint Commission, 2015). Additionally, JCAHO offers essential guidelines for managing pressure ulcer development, which is focused on mitigating the development of this condition at their Stage one of development.

Additionally, the National Database of Nursing Quality Indicators (NDNQI) has also ascertained that pressure ulcer development is a critical problem affecting most patients in healthcare facilities (Roux & Halstead, 2017). As such, the NDNQI has developed a training program for healthcare practitioners, which is focused on improving the nursing accuracy and reliability in the identification and staging of pressure ulcers. The program is also designed to provide a differentiation between the hospital-acquired pressure ulcers (HAPU), and the community-acquired pressure ulcers (CAPU).

Background Information

Several types of research have been conducted in the past few years, which detail the impact of various interventions used in the treatment of pressure ulcers. In most cases, such kind of researches was focused on validating why a specified intervention should be considered the best in treating a particular form of pressure ulcers. In terms of the current research, four primary research publications were employed to expound the scale of knowledge for this study. Among such publications is research authored by Mallah, Nassar, and Badr (2015).

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The research was focused on ascertaining the effectiveness of multidisciplinary interventions in assessing which of the featured methodologies was effective in reducing the rate of HAPU development. The sample population used during the research consisted of four hundred and sixty-eight patients in a tertiary medical facility in Lebanon. The findings of the research demonstrated that such intervention as the use of skincare management reduced the rate of HAPU from six-point six three percent to two point four seven percent only in 2012 (Mallah, Nassar & Badr, 2015). The Braden Scale was employed to measure the change.

In the course of the research, the group used the information included in the research by Mallah, Nassar, and Badr (2015) to support the hypothesis that pressure ulcers are a critical problem faced by numerous patients in medical institutions. Additionally, the researchers ascertained that through the identification and implementation of effective pressure ulcer interventions, HAPU development could be controlled if not managed completely. Furthermore, the research provided the group with guidance on adopting a skin management intervention as a strategy to manage pressure ulcer development. Arguably, this was the reason the group decided to use a GPS tracker as one of the pressure ulcer management interventions for the current research.

The second research publication that was employed for this research was authored by Still et al. (2013). The research study was focused on ascertaining whether the turning and repositioning of the hemodynamically stable patients could help in the reduction of pressure ulcer development. The findings of the research illustrated that the rate of pressure ulcer development could be significantly reduced by a team of healthcare personnel charged with the responsibility of turning and repositioning the SICU patients every two hours.

From Still et al.'s (2013)s research, it became evident that the group supported the formulation of the research problem in a sense that pressure ulcer attainment is a serious healthcare issue affecting a large number of hospitalized patients. According to the research, pressure ulcers have caused an increment in the morbidity and mortality rates among patients admitted to the surgical intensive care unit (SICU) (Still et al., 2013). Also, from the research, the group learned that stage I and stage II ulcer development can be averted by using the specialized team to reposition patients on hospital beds.

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Furthermore, the researchers also analyzed a research publication that was authored by Zaratkiewicz et al. (2010). The research was focused on the development and implementation of a HAPU incidence tracking system and an algorithm among patients admitted to clinics. Additionally, the research sought to determine whether HAPU was avoidable through the use of the tracking system to monitor and implement an effective intervention necessary for controlling pressure ulcer development. Also, it is worth noting that the tracking system and the algorithm as viable interventions for HAPU prevention had been developed by the Harborview Medical Center, which is situated in Seattle, United States.

From the research, the group learned that HAPUs had been a matter of national concern in the United States. This is due to their increment in patients morbidity, reimbursement issues as well as treatment costs. This knowledge further supported the development of the problem statement for the research confirming that pressure ulcers have become a major issue affecting patients in numerous healthcare institutions in the United States. Furthermore, the findings of the study illustrated that the use of a tracking system could be effective in the management of HAPU development amongst bed-bound patients.

In the research of Zaratkiewicz et al. (2010), the Harborview Medical Centres tracking system and an algorithm were employed to track HAPU development. The system was effective in helping the medical institution to track and prevent pressure ulcers in compliance with the regulations. Subsequently, such efforts enabled the medical practitioners to secure an improved skin-condition outcome. Also, due to its effectiveness, the group decided to adopt a GPS tracking system that could also be employed as an effective intervention for HAPU management.

Additionally, research published by Keane (1979) was also employed in the development of the research problem statement. The research focused on the usage of conventional paraplegic nursing as a skincare management intervention for patients suffering from pressure ulcers. Additionally, this intervention entailed the turning of hospitalized patients in a two to three hours interval. Moreover, the findings of the research demonstrated that the repositioning of patients on hospital beds was an effective intervention in terms of managing and preventing the development of pressure ulcers among these patients.

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The findings of this research offered the group a piece of knowledge to support its problem statement, according to which pressure ulcers are a problem affecting a large number of patients and the healthcare sector as a whole. Furthermore, the findings of Keane's (1979)s research also supported the need for the development of a specialized team for cleaning and repositioning patients as an effective intervention to manage HAPU. This is a viable solution that can be employed to reduce the rate of pressure ulcer development by sixty-five percent. Additionally, it can also be a solution that can be used to reduce the level of bedsores development from stage four to stage two within a three months timeframe.

Further, this research also employed the findings from the research published by Chou et al. (2013). The research was focused on investigating the clinical effectiveness of the pressure ulcer assessment instruments used for hospitalized patients. Additionally, the findings of the research illustrated that effective instruments for treating pressure ulcers could be employed for the management and prevention of HAPU. Also, they could be used among patients who are at a higher risk of developing HAPU due to factors such as age and clinical condition.

Additionally, the research by Chou et al. (2013) portrayed that pressure mattresses could be employed as an effective intervention for treating and managing pressure ulcers. However, the research illustrated that there is a need for further research to be performed on the state-of-art interventions that can be employed for the treatment and prevention of pressure ulcers. Also, from Chou et al.'s (2013)s research, the group learned that pressure ulcers had become a major issue in the healthcare sector.

This is because according to Chou et al. (2013), this condition is associated with the development of substantial healthcare burdens, which with appropriate interventions can be successfully prevented or managed. Additionally, the findings from the research by Chou et al. (2015) also contributed to the development of the problem statement that was employed for the current research. It also helped in the identification of the need to conduct further research focusing on determining some of the alternatives to pressure mattresses, which could also be effectively employed for HAPU treatment and prevention.

Narrative Summary

From the research, it is evident that the two featured interventions are highly effective and can be employed for the management and prevention of pressure ulcer development. This is because the effectiveness of their usage has been validated and supported by numerous featured research publications. Furthermore, the difference in the two featured interventions can only be evidenced if there is variation in the implementation of either of the two interventions.

Additionally, tracking of the periods, during which a hospitalized patient should change or shift his/her weight, is of paramount importance. This is because it ensures that a patient does not apply an immense amount of pressure on a single side or his/her entire body. Consequently, this will ensure that the pressurized regions of a person's body are not bruised over time. Also, the use of a tracking system can help both the patient and healthcare practitioners to schedule appropriate time intervals, during which the weight of one's body should be shifted.

Furthermore, if used correctly, this form of intervention can completely eradicate the problem of pressure ulcer development among patients. Other publications that have supported the use of a tracking system to prevent and manage pressure ulcers include the research done by Khan et al. (2016). The research demonstrated that a tracking app could be employed by patients who use wheelchairs to help them avoid phase II spinal cord injuries. In such a way, the tracker app can be set up on a patient's mobile device, such as a smartphone.

Also, through the use of such a tracker, the patient can be reminded at regular intervals or the most appropriate time for him/her to change his/her weight position. On the other hand, the use of qualified medical practitioners to manually change the position of hospitalized patients has also been ascertained to be a highly effective intervention for preventing the development of pressure ulcers. This is because nursing practitioners that are responsible for caring for bed-bound patients can schedule appropriate intervals of changing the position of patients.

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Also, other researches have been conducted in the past in support of the effectiveness of manual repositioning of patients for the management and prevention of pressure ulcers. Among them is the research that was carried out by Gillespie et al. (2014). The research represented a randomized controlled trial and validated the use of a repositioning technique as an effective strategy for preventing and managing the development of pressure ulcers. In this case, qualified nursing practitioners are assigned the task to reposition the bed-bound patients at regular intervals to significantly reduce the risk of pressure ulcer development.

Additionally, according to a scientific publication authored by John Maynard (2015), the accepted guideline for care about pressure ulcers states that a patient should be turned in every two hours. Also, this publication stated that the repositioning of patients should depend on a variety of factors that will help the practitioner to find the right position for the patient (Maynard, 2015). In this regard, some examples of such factors include the level of the patient's mobility and activity, his/her medical and skin condition, as well as his/her treatment peculiarities.

Furthermore, the repositioning of patients should also be dependent on the level of their tissue tolerance as well as their comfort levels (Maynard, 2015). Also, according to the National Institute for Health and Care Excellence (NICE), repositioning patients is a viable intervention for preventing pressure ulcers (NICE, 2015). The publication stated that lack of mobility and sensations is the primary risk factor that is associated with the development of pressure ulcers (NICE, 2015). Also, the research stated that to remedy such a situation, the patient repositioning technique by healthcare practitioners can be used in preventing the escalation of pressure ulcers.

Conclusion

There still exists a problem of pressure ulcer development among patients who are on the mechanical ventilator equipment in medical facilities along with bed-bound patients. However, a GPS device to track the rate at which hospitalized patients turn or reposition their bodies can be an effective intervention for managing and preventing pressure ulcer development. Additionally, a specialized nursing team can also be trained to wash and reposition patients to prevent and manage the development of HAPU. Both of these interventions have been validated by numerous researches that have been conducted in the past. As such, both of them are effective techniques that can be used in a clinical setting. Ultimately, the problem of pressure ulcer development has been linked to several national qualities as well as safety indicators. This is because JCAHO and NDNQI have acknowledged that pressure ulcers are a critical healthcare problem affecting the healthcare sector in the United States. However, through the use of a GPS tracking system and the manual repositioning of bed-bound patients, the pressure ulcer problem can be significantly mitigated if not eradicated.

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