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Prevention and care of pressure ulcers - evidence based paper

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Prevention and care of pressure ulcers - evidence based paper
�PAGE � �PAGE �1� Prevention and Care of Pressure Ulcers

Running head: PREVENTION AND CARE OF PRESSURE ULCERS

Prevention and Care of Pressure Ulcers

NUSC 434

PREVENTION AND CARE OF PRESSURE ULCERS

Pressure ulcers are a commonly seen problem among elderly hospitalized patients. Despite new findings about the causes and approaches to treatment, the incidence of these wounds is still increasing. Scott, Gibran, Engrav, Mack and Rivara (2006) revealed that during the thirteen years of their study, the incidence of pressure ulcer development has more than doubled. As our elderly population becomes greater in number, and older in age, this problem is expected to escalate. It is of great importance for the patients as well as for the institutions to find the best practice guidelines to control the occurrence of preventable wounds. Many hospitals incorporate strict prevention measures with good effects, and others are more concentrated on treating the problem after it occurs, without paying much attention to prevention. In XY hospital, patients at risk do not receive the necessary preventive care, and many patients' existing wounds often become infected, and instead of healing, they deteriorate. This paper will review the research regarding the best prevention methods, as well as the best evidence based treatment of pressure ulcers, followed by suggestions how to implement those findings in XY hospital.

PICO QUESTION

In elderly and immobile patients, what are the most effective prevention and treatment methods to reduce the occurrence and complications of pressure ulcers, compared to no prevention and standard wet-to-dry dressings?

SUMMARY AND APPLICATION OF RESEARCH ARTICLES

Effective management of pressure ulcers begins with a comprehensive assessment of the patient, with careful consideration of the risk factors. Hess (2004) reported that the Braden Scale is the most commonly used risk assessment tool. Also, it is important to regularly inspect the skin of the



References: Bethell, E. (2005). Wound care for patients with darkly pigmented skin. _Nursing Standard, 20_ (4), 41-49. Retrieved April 14, 2006, from OVID MEDLINE database. Cobb, D.K., Warner, D. (2004). Avoiding malpractice: the role of proper nutrition and wound management. _Journal of the American Medical Directors Association, 5_ (4 Suppl), H11-6. Retrieved April 14, 2006, from OVID MEDLINE database. Dowsett, C. (2004). The use of silver-based dressings in wound care. _Nursing Standard, 19_ (7), 55-58. Retrieved April 14, 2006, from OVID MEDLINE database. Grey, J.E., Harding, K.G., Enoch, S. (2006). Pressure ulcers. _BMJ, 332_ (7539), 472-5. Retrieved April 14, 2006, from OVID MEDLINE database. Hess, C.T. (2004). Care tips for chronic wounds: pressure ulcers. _Advances in Skin and Wound Care, 17_ (9), 477-9. Retrieved April 14, 2006, from OVID MEDLINE database. Maklebust, J. (2005). Choosing the right support surface. _Advances in Skin and Wound Care, 18_ (3), 158-61. Retrieved April 14, 2006, from OVID MEDLINE database. Marquis, B.L., Huston, C.J. (2006). _Leadership roles and management functions in nursing._ Philadelphia, PA: Lippincott Williams and Wilkins. McGuckin, M., Goldman, R., Bolton, L., Salcido, R. (2003). The clinical relevance of microbiology in acute and chronic wounds. _Advances in Skin and Wound Care, 16_ (1), 12-23. Retrieved April 14, 2006, from OVID MEDLINE database. Ovington, L.G. (2001). Hanging wet-to-dry dressings out to dry. _Home Healthcare Nurse, 19_ (8), 477-83. Retrieved April 14, 2006, from OVID MEDLINE database. Wysocki, A.B. (2002). Evaluating and managing open skin wounds: colonization versus infection. _AACN Clinical Issues, 13_ (3), 382-97. Retrieved April 14, 2006, from OVID MEDLINE database.

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