Nursing Problem
A pressure injury, commonly known as bedsore, is a form of skin injury that occurs when external forces cause the skin to break and usually occurs in bedridden patients (Kirman, 2019). Moreover, a pressure injury can also happen when force is applied to the skin’s surface. This pressure may be exerted as a constant squeezing of a small skin area or administered by dragging or shearing the skin over another surface. The hips, heels, tailbone, elbows, head, and ankles are common sites for these injuries (Kirman, 2019). Allowing a pressure wound to deepen or get infected increases the risk that it may become a life-threatening condition. Despite implementing various prevention strategies, pressure injuries remain a persistent problem in healthcare settings. Therefore, there is a need to identify evidence-based interventions that can effectively prevent pressure injuries in patients.
PICOT
Population
In this case, the population is patients in acute care settings with limited mobility or bedridden because of their conditions.
Intervention
The implementation of pressure ulcer prevention protocols includes aspects such as regular repositioning, risk assessment, skin and tissue evaluation, preventative skin care, repositioning, nutrition, and the use of supportive surfaces are all interventions (Kirman, 2019).
Comparison of Control
Another intervention that can be considered includes creating a unified team to tackle and respond to cases and incidents of pressure injuries in immobile patients. The multidisciplinary team can consist of a nurse manager, a nurse, a pharmacist, and a doctor, all tasked with reducing the impact pressure injuries have on the overall health of the patient and creating interventions to prevent future related occurrences.
Outcome or Objective
The incidence of pressure injuries will be measured using the National Pressure Ulcer Advisory Panel (NPUAP) staging system (Edsberg et al., 2016). The incidence of pressure injuries will be compared before and after implementing the pressure ulcer prevention protocol.
Time Frame
Moreover, the pressure ulcer prevention protocol will be implemented over three months.
PICOT Question
In elderly and immobile patients, can implementing a pressure injury prevention protocol, compared to standard care, essentially reduce the incidences of pressure injuries if implemented over three months? In addition, what are some of the barriers that can prevent the implementation of pressure injury interventions and the factors that can allow for implementing these protocols?
Course Principle
One principle will be employed in the evaluation of peer-reviewed literature. The literature will be from nursing databases, such as the school library and Google Scholar, and other sources, such as PubMed, which supports the use of pressure ulcer prevention protocols in preventing pressure injuries in patients. A risk assessment, skin and tissue evaluation, preventative skin care, repositioning, nutrition, and supportive surfaces are all recommended to reduce the likelihood of pressure injuries. The industry in which nurses work, their level of training and experience in pressure ulcer prevention, and their ability to spot these sores in their patients early all have a role in preventing and reducing the incidences of the development of pressure injuries.
Moreover, one source that will be used includes Our contemporary understanding of the etiology of pressure ulcers or pressure injuries by Gefen et al. (2021), which provides a brief etiology and physiopathology understanding of how pressure ulcers come about and their impact on the body. Another additional source that will be used includes Optimizing Nutrition Care for Pressure Injuries in Hospitalized Patients by Citty et al. (2019), which looks into interventions that can be put in place to reduce the impact of pressure ulcers on the individual. These and other articles will be incorporated as part of the peer reviews and evidence-based approaches to reduce the development of pressure ulcers.
References
Citty, S. W., Cowan, L. J., Wingfield, Z., & Stechmiller, J. (2019). Optimizing Nutrition Care for Pressure Injuries in Hospitalized Patients. Advances in Wound Care, 8(7), 309–322. https://doi.org/10.1089/wound.2018.0925
Edsberg, L. E., Black, J. M., Goldberg, M., McNichol, L., Moore, L., & Sieggreen, M. (2016). Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System. Journal of Wound, Ostomy and Continence Nursing, 43(6), 585–597. https://doi.org/10.1097/won.0000000000000281
Gefen, A., Brienza, D. M., Cuddigan, J., Haesler, E., & Kottner, J. (2021). Our contemporary understanding of the etiology of pressure ulcers/pressure injuries. International Wound Journal, 19(3). https://doi.org/10.1111/iwj.13667
Kirman, C. N. (2019). Pressure Injuries (Pressure Ulcers) and Wound Care: Practice Essentials, Background, Anatomy. EMedicine. https://emedicine.medscape.com/article/190115-overview
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