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Published byLeo Skinner Modified over 9 years ago
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By: Emily Ebright
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Cause: Prolonged pressure on skin and tissue especially bony points, decreases blood flow to these areas. Affected skin and tissue are deprived of nutrients and oxygen and start to die. Contributing factors: Immobility, mental and physical impairments, excess weight, increased age, dehydration, poor nutrition, bowel and bladder incontinence, smoking, and poor perfusion.
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Complications: Infection and sepsis, loss of quality of life, decreased life expectancy, cellulitis, bone and joint infection, and a form of cancer caused by wounds that heal slowly. Scope of problem: National Avg: 5 % Local avg: 1.6%- 5% (Ayello, E. and Sibbald, G., 2012) (IMayo Clinic, 2015)
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For the Patient Longer healing times Weakened immune system Loss of quality of life Longer stays in a facility For the Institution Decrease in the amount of reimbursement Wasted resources Poor statistics and ratings (possible loss of business) For healthcare resources Wasted on preventable condition Increased spending (Nationwide 11 billion a year to treat) (Reddy, M., Gill, S., Rochon, P., 2006)
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For patient care: Ensure proper nutrition and hydration Monitor and measure ulcers Record progression of healing For prevention/prophylaxis: Ensure turning schedule is enforced Skin checks Keep patient dry- bowel and bladder program Position with bony parts padded and reduce pressure on high risk parts Initiate pressure sore prevention protocol for high risk patients. Staff and patient education on ulcers. Prevent and reduce sheering to the skin.
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Assess: Skin Checks Identify high risk patients Address skin concerns early Initiate interventions early Plan Change position q2 Keep clean and dry Position off bony parts Increase hydration and nutritional intake (protein)
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Intervene Dressings to cover risk areas Protect bony prominences Increase Protein and caloric supplementation (snacks and shakes) Specific plan of care for turning (turn sheet) Create bowel and bladder program Special weight distribution bed Frequent skin assessment Encourage as much independence and mobility as possible Evaluate Measure and evaluate healing and thoroughly document Evaluate need for change in current plan. Frequently assess skin for risk areas
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Initiatives Skin check with 2 nurses on admission to the unit. Braden daily skin assessment Hyperbaric Chamber Education Informational Pamphlets Online: National Pressure Ulcer Advisory Panel Mayo Clinic
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Ayello, E. and Sibbald, G.( 2012). Hartford Institute for Geriatric Nursing, Nursing standard of practice protocol: Pressure ulcer prevention & skin tear prevention. Retrieved from: http://consultgerirn.org/topics/pressure_ulcers_and _skin_tears/want_to_know_more#item_4 Mayo Clinic. (2015). Diseases and Conditions: Bedsores, Retrieved from: http://www.mayoclinic.org/diseases- conditions/bedsores/basics/complications/con- 20030848 Reddy, M., Gill, S., Rochon, P. (2006) The Journal of American Medical Association. Preventing pressure ulcers: A systematic review. Retrieved from: http://jama.jamanetwork.com/article.aspx?articleid =203227
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