Pressure Ulcers and Safety Issues
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Powerpoint Presentation on BedSores, or Pressure Ulcers. These are lesions often caused when tissues hit bone for a lengthy amount of time, restricting blood flow. They are quite common in nursing homes, long-term care facilities, and even in hospices. Pressure ulcers are serious medical conditions, and exacerbated by other conditions like diabetes, perspiration, incontinence, infections or medications.
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By: Vannelyn Oriel
1
Problem Definition
In this case, pressure ulcers is the problem that was identified.
Pressure ulcers refer to injuries to the skin and underlying tissue and this is can be attributed to prolonged pressure on the skin.
Today, pressure ulcers is increasingly becoming a major health concern globally.
Healthcare systems worldwide continue to direct resources towards helping patients effectively and efficiently manage pressure ulcers.
Pressure ulcers is becoming a major health concern globally.
It root cause is prolonged pressure on the skin.
It mostly affects patients in hospitals.
Few studies have focused on assessing this healthcare problem.
It is a pattern that I would like to change to improve quality.
2
Pressure Ulcers
According to data from the Agency for Healthcare Research and Quality (AHRQ), more than 2.5 million people in the U.S. develop pressure ulcers annually.
Pressure ulcers especially among patients recovering in hospitals bring pain.
The healthcare problem also leads to increased health care utilization.
There is increase risk for serious infection among patients in hospitals.
Overall, documented cases of pressure ulcers has been on an upward trend globally.
In most cases, pressure ulcers develop among patients who have a specific health condition that limits their ability to change positions.
3
Symptoms and Causes of Pressure Ulcers
There exist various symptoms and causes of pressure ulcers.
The first symptom is unusual changes in a patient’s skin color or texture.
Increased tenderness of skin areas.
Swelling can be observed.
Pus-like draining is another symptom.
Bedsores can be categorized into different stages that cause pressure ulcers.
Common areas for pressure ulcers
Buttocks.
Back of legs, and arms where a patient rests against the chair.
Shoulder and spine.
4
Risk Factors
Immobility for example, assuming a patient in hospital is using a wheelchair, they would apply pressure to specific parts such as buttocks leading to pressure ulcers.
Incontinence where a patient’s skin becomes susceptible due to extended exposure to urine and stool.
Poor diet and nutrition leading to lack of vitamins and minerals that can lead to a healthy skin.
Patients with diabetes also have high risk of experiencing pressure ulcers.
Pressure ulcers if not well managed and treated among patients can lead to complications such as cancer, and bone and joint infections.
5
Description of the Problem
Pressure ulcers is a major health concern in today’s nursing practice.
Despite so, it is largely preventable in nature.
The management of pressure ulcers relies on its severity.
A study by Surg, 2015 established that cleaning of wound, using antibiotics, and undergoing reconstructive surgery were the present treatment options for pressure ulcers (Surg, 2015).
However, there exist newer treatment options such as cell therapy, wound therapy and wound therapy.
...
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3. Treatment depends on the type and severity of injury but may involve surgery, antibiotics, intravenous fluids, blood transfusions, and careful monitoring for complications like infection, bleeding, or organ failure. Nursing care focuses on pain management
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This document discusses pressure sores, also known as bed sores or pressure ulcers. It defines pressure sores as soft tissue injuries caused by unrelieved pressure over bony prominences. Pressure sores are staged from Stage I to Stage IV based on the depth of tissue damage, with Stage IV involving bone or joint damage. Risk factors include aging, immobility, moisture, malnutrition, and friction or shear forces. Surgical treatment involves debridement, wound closure, and various flap procedures depending on the location of the pressure sore. Postoperative care focuses on nutrition, medical management, nursing care, and wound monitoring to prevent recurrence or progression.
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©2016 American Association of Critical-Care Nursesdoi http.docx
©2016 American Association of Critical-Care Nurses
doi: http://dx.doi.org/10.4037/ajcc2016979
Pressure Ulcer Management
Background Patients in intensive care units are likely to
have limited mobility owing to hemodynamic instability
and activity orders for bed rest. Bed rest is indicated
because of the severity of the disease process, which
often involves intubation, sedation, paralysis, surgical
procedures, poor nutrition, low flow states, and poor cir-
culation. These patients are predisposed to the develop-
ment and/or the progression of pressure ulcers not only
because of their underlying diseases, but also because
of limited mobility and deconditioned states of health.
Objective To assess whether treating high-risk patients
with a prophylactic sacral dressing decreases the inci-
dence of unit-acquired sacral pressure ulcers.
Methods An evidence-based tool for identifying patients
at high risk for pressure ulcers was used in 3 intensive
care units at an urban tertiary care hospital and academic
medical center. Those patients deemed at high risk had
a prophylactic sacral dressing applied. Incidence rates
were collected and compared for the 7 months preced-
ing use of the dressings and for 7 months during the
trial period when the dressing was used.
Results After the sacral dressing began being used, the
number of unit-acquired sacral pressure ulcers decreased
by 3.4 to 7.6 per 1000 patient days depending on the unit.
Conclusions A prophylactic sacral dressing may help
prevent unit-acquired sacral pressure ulcers. Implemen-
tation of an involved care team with heightened aware-
ness and increased education along with a prophylactic
sacral dressing in patients deemed high risk for skin
breakdown are all essential for success. (American Jour-
nal of Critical Care. 2016;25:228-234)
PROPHYLACTIC SACRAL
DRESSING FOR PRESSURE
ULCER PREVENTION IN
HIGH-RISK PATIENTS
By Jaime Byrne, RN, MSN, CCRN, Patricia Nichols, RN, MSN, CCRN, Marzena
Sroczynski, RN, BSN, CWOCN, Laurie Stelmaski, RN, BSN, CWON, Molly Stetzer,
RN, BSN, CWOCN, Cynthia Line, PhD, and Kristen Carlin, MPH
228 AJCC AMERICAN JOURNAL OF CRITICAL CARE, May 2016, Volume 25, No. 3 www.ajcconline.org
P
atients in intensive care units (ICUs) are predisposed to pressure ulcers because of
limited mobility and the severity of their disease processes. Pressure ulcers result
from pressure or a combination of pressure and shear, usually over bony promi-
nences, and cause localized injury to the skin and underlying tissues.1 The prevalence
of pressure ulcers in acute care settings is estimated at 12% to 19.7%, of which 20%
occur on the sacrum or coccyx.2 In ICUs, pressure ulcers rates can occur in 14% to 42% of
patients.3 For patients, pressure ulcers can be painful, embarrassing, isolating, and, in some
cases, life-threatening.4
The standard of care to prevent pressure ulcers
includes routine repositioning to offload pressure
.
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Comment1
Nursing practice has changed in how nurses handle and care for central lines as well as how central lines are inserted specifically peripherally inserted central catheters. The reduction of CLABSI’s (central line associated blood stream infection) and the use of an insertion bundle have greatly improved patient outcomes in the last many years. These practice changes have reduced patient mortality and decreased the length of patient stay in the ICU. Through these studies and by implementation of new processes brings awareness to nursing staff on what needs to be done to better care and protect our patients. The findings have changed my overall view of central lines. When I cared for central lines I was more careful at assessing, accessing, documenting and advocating for earlier removal of these devices when no longer needed in my patient. At the hospital where I work, dressing changes of central lines are a two person process and the use of CUROS caps to cover needless connectors or injectable ports on tubing is required to prevent infection. The insertion bundle is utilized by our PICC team who do their part in following strict guidelines when placing the central line catheter.
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1. Obtaining wound cultures (both superficial and deep tissue) to help guide antibiotic selection.
2. Surgical debridement of the wound to remove non-viable tissue and optimize assessment of wound depth and surrounding soft tissues.
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It often causes a person’s neck and jaw muscles to lock, making it hard to open the mouth or swallow
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Healthcare Problem PresentationBy Vannelyn Oriel1
Healthcare Problem Presentation
By: Vannelyn Oriel
1
Problem Definition
In this case, pressure ulcers is the problem that was identified.
Pressure ulcers refer to injuries to the skin and underlying tissue and this is can be attributed to prolonged pressure on the skin.
Today, pressure ulcers is increasingly becoming a major health concern globally.
Healthcare systems worldwide continue to direct resources towards helping patients effectively and efficiently manage pressure ulcers.
Pressure ulcers is becoming a major health concern globally.
It root cause is prolonged pressure on the skin.
It mostly affects patients in hospitals.
Few studies have focused on assessing this healthcare problem.
It is a pattern that I would like to change to improve quality.
2
Pressure Ulcers
According to data from the Agency for Healthcare Research and Quality (AHRQ), more than 2.5 million people in the U.S. develop pressure ulcers annually.
Pressure ulcers especially among patients recovering in hospitals bring pain.
The healthcare problem also leads to increased health care utilization.
There is increase risk for serious infection among patients in hospitals.
Overall, documented cases of pressure ulcers has been on an upward trend globally.
In most cases, pressure ulcers develop among patients who have a specific health condition that limits their ability to change positions.
3
Symptoms and Causes of Pressure Ulcers
There exist various symptoms and causes of pressure ulcers.
The first symptom is unusual changes in a patient’s skin color or texture.
Increased tenderness of skin areas.
Swelling can be observed.
Pus-like draining is another symptom.
Bedsores can be categorized into different stages that cause pressure ulcers.
Common areas for pressure ulcers
Buttocks.
Back of legs, and arms where a patient rests against the chair.
Shoulder and spine.
4
Risk Factors
Immobility for example, assuming a patient in hospital is using a wheelchair, they would apply pressure to specific parts such as buttocks leading to pressure ulcers.
Incontinence where a patient’s skin becomes susceptible due to extended exposure to urine and stool.
Poor diet and nutrition leading to lack of vitamins and minerals that can lead to a healthy skin.
Patients with diabetes also have high risk of experiencing pressure ulcers.
Pressure ulcers if not well managed and treated among patients can lead to complications such as cancer, and bone and joint infections.
5
Description of the Problem
Pressure ulcers is a major health concern in today’s nursing practice.
Despite so, it is largely preventable in nature.
The management of pressure ulcers relies on its severity.
A study by Surg, 2015 established that cleaning of wound, using antibiotics, and undergoing reconstructive surgery were the present treatment options for pressure ulcers (Surg, 2015).
However, there exist newer treatment options such as cell therapy, wound therapy and wound therapy.
...
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Diabetic foot ulcers are a major complication of diabetes and a leading cause of non-traumatic lower extremity amputations. They result from an interaction of neuropathy, abnormal foot biomechanics, peripheral arterial disease, and poor wound healing in diabetes patients. Ulcers are classified based on their depth and degree of ischemia. Treatment involves strict glycemic control, antibiotic treatment of infections, wound care including debridement and dressings, and offloading pressures on the foot. Prevention relies heavily on patient education regarding foot care, protective footwear, and monitoring for early signs of infection or other issues.
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3. Treatment depends on the type and severity of injury but may involve surgery, antibiotics, intravenous fluids, blood transfusions, and careful monitoring for complications like infection, bleeding, or organ failure. Nursing care focuses on pain management
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This document discusses pressure sores, also known as bed sores or pressure ulcers. It defines pressure sores as soft tissue injuries caused by unrelieved pressure over bony prominences. Pressure sores are staged from Stage I to Stage IV based on the depth of tissue damage, with Stage IV involving bone or joint damage. Risk factors include aging, immobility, moisture, malnutrition, and friction or shear forces. Surgical treatment involves debridement, wound closure, and various flap procedures depending on the location of the pressure sore. Postoperative care focuses on nutrition, medical management, nursing care, and wound monitoring to prevent recurrence or progression.
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©2016 American Association of Critical-Care Nursesdoi http.docx
©2016 American Association of Critical-Care Nurses
doi: http://dx.doi.org/10.4037/ajcc2016979
Pressure Ulcer Management
Background Patients in intensive care units are likely to
have limited mobility owing to hemodynamic instability
and activity orders for bed rest. Bed rest is indicated
because of the severity of the disease process, which
often involves intubation, sedation, paralysis, surgical
procedures, poor nutrition, low flow states, and poor cir-
culation. These patients are predisposed to the develop-
ment and/or the progression of pressure ulcers not only
because of their underlying diseases, but also because
of limited mobility and deconditioned states of health.
Objective To assess whether treating high-risk patients
with a prophylactic sacral dressing decreases the inci-
dence of unit-acquired sacral pressure ulcers.
Methods An evidence-based tool for identifying patients
at high risk for pressure ulcers was used in 3 intensive
care units at an urban tertiary care hospital and academic
medical center. Those patients deemed at high risk had
a prophylactic sacral dressing applied. Incidence rates
were collected and compared for the 7 months preced-
ing use of the dressings and for 7 months during the
trial period when the dressing was used.
Results After the sacral dressing began being used, the
number of unit-acquired sacral pressure ulcers decreased
by 3.4 to 7.6 per 1000 patient days depending on the unit.
Conclusions A prophylactic sacral dressing may help
prevent unit-acquired sacral pressure ulcers. Implemen-
tation of an involved care team with heightened aware-
ness and increased education along with a prophylactic
sacral dressing in patients deemed high risk for skin
breakdown are all essential for success. (American Jour-
nal of Critical Care. 2016;25:228-234)
PROPHYLACTIC SACRAL
DRESSING FOR PRESSURE
ULCER PREVENTION IN
HIGH-RISK PATIENTS
By Jaime Byrne, RN, MSN, CCRN, Patricia Nichols, RN, MSN, CCRN, Marzena
Sroczynski, RN, BSN, CWOCN, Laurie Stelmaski, RN, BSN, CWON, Molly Stetzer,
RN, BSN, CWOCN, Cynthia Line, PhD, and Kristen Carlin, MPH
228 AJCC AMERICAN JOURNAL OF CRITICAL CARE, May 2016, Volume 25, No. 3 www.ajcconline.org
P
atients in intensive care units (ICUs) are predisposed to pressure ulcers because of
limited mobility and the severity of their disease processes. Pressure ulcers result
from pressure or a combination of pressure and shear, usually over bony promi-
nences, and cause localized injury to the skin and underlying tissues.1 The prevalence
of pressure ulcers in acute care settings is estimated at 12% to 19.7%, of which 20%
occur on the sacrum or coccyx.2 In ICUs, pressure ulcers rates can occur in 14% to 42% of
patients.3 For patients, pressure ulcers can be painful, embarrassing, isolating, and, in some
cases, life-threatening.4
The standard of care to prevent pressure ulcers
includes routine repositioning to offload pressure
.
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Pressure Ulcers and Safety Issues
- 2. Lesions often caused when soft tissues are pressed against bone for a long-period, which then restricts blood flow. Quite common in nursing homes and long-term or hospice care centers. Exacerbated by other conditions like diabetes, perspiration, incontinence, infections or medications that may impair the circulatory system.
- 3. Intrinsic Aging Chronic Disease Impaired Mobility Limited Activity Fecal Incontinence Malnutrition Sensory Impairment Extrinsic Pressure Friction Shearing Limited Activity Moisture
- 4. BEST TREATED THROUGH PREVENTATIVE CARE Turning the patient regularly Using catheters or impermeable dressings Shifting paralyzed patients Using Pressure-Distributive mattresses Increasing Vitamin-C intake
- 5. Pressure Ulcers in America: Prevalence, Incidence, and Implications for the Future. (2001). Advanced Skin and Wound Care. 14 (4): 208- 15. Preventing and Treating Pressure Ulcers. (2009). UCan Health. Retrieved from: http://ucanhealth.com/topics/?T=pressure_ ulcer_amyotrophic_lateral_sclerosis_ALS Preventing Pressure Ulcers in Hospitals. (2011). Agency for Healthcare Research and Quality. Retrieved from: http://www.ahrq.gov/ research/ltc/pressureulcertoolkit/ Gefen, A. (2008). How Much Time Does it Take to Get a Pressure Ulcer? Ostomy Wound Management. 54 (10) 26-35. Retrieved from: http://www.o-wm.com/content/how-much-time-does-it-take-get- a-pressure-ulcer-integrated-evidence-human-animal-and-in-vitr
- 6. Complications: Pain Dermal Damage Bleeding Infection Use of Best Practices Methods for preventing and treating pressure ulcers – AWARENESS! Effectiveness Outcomes: Wound healing Prevention of Sepsis Diminishing recurrence rate
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