The article Pressure Ulcers: A Patient Safety Issue by Courtney Lyder and Elizabeth Ayello talks about the safety issues concerning patients with pressure ulcers. The article begins by stating that pressure ulcer is a critical healthcare problem affecting more than 3 million people. Furthermore, the report argues that between 1993 and 2006 the healthcare cost of treating and stabilizing pressure ulcers increased by 63 percent (Lyder, & Ayello, 2008). The authors of the article state that many healthcare physicians believe that pressure ulcers are not a problem that is mainly associated with nonexistent or poor nursing care but the failure of the whole healthcare system. The incidences of pressure ulcers range from 2.2 to 23.9 % in skilled nursing facilities, 0.4 to 38 % in hospital, and 0 to 17 % in home health agencies (Lyder, & Ayello, 2008). From this, the article concludes that majority of the pressure ulcers occur during the early admissions process. Similarly, the report argues that 15 % of the older adults who are hospitalized develop pressure ulcers.
The authors argue that pressure ulcers mainly develop when the capillaries responsible for supplying blood to the subcutaneous tissue and skin become compressed to impede perfusion resulting in tissue necrosis. Some of the risk factors that the article identify are both intrinsic and extrinsic and they include diabetes mellitus, cerebral vascular accident, hypotension, peripheral vascular disease, and sepsis (Lyder, & Ayello, 2008). Other additional factors related to the development of pressure ulcers appear with old age, and they include dry skin, impaired mobility malnutrition, and malignancy. The standard risk assessment tool used is Norton or Braden Scale. The article indicates that not all pressure ulcers wounds can be prevented, but through comprehensive approach much can be achieved. The report concludes that nursing remains them institution and profession of safeguarding and preventing patients from pressure ulcers.
Bundle up to prevent pressure ulcers
The Bundle up to prevent pressure ulcers is by Mary Elizabeth Paciella and mainly talks of preventing pressure ulcers. The article begins by stating that pressure ulcers is not a simple would and can heal through the right treatment. The author goes on to state that the wound can have adverse effects on the quality of life of the patient and his or her family. The article estimates that about 2.5 million patients in the U.S develop pressure ulcers and the nation spends $11 billion treating the condition (Paciella, 2017). Further, the article states that most clinical officers and physicians argue that all pressure ulcers wounds can be prevented and also admit that some of the wounds may be harder to avoid than others and while others require more aggressive interventions.
The article states that the primary prevention strategy or approach pushed forward by Institute for Healthcare Improvement (IHI) id the bundle prevention approach. The method is a straightforward with simple intervention resulting in improved patient outcomes. The strength of the bundle pressure is within its all-or-nothing nature. To have the desired outcomes, the physicians and the caregivers must complete all the steps of the bundle approach. Furthermore, the article argues that have successful prevention program or stagey the healthcare facility must know its pressure ulcer prevalence rate and compares it with other healthcare facilities similar populations. The critical elements of the bundle prevention method include starting with head-to-toe skin assessment of a patient during the admission and further evaluation of all patients during every shift (Paciella, 2017). Other important elements include repositioning and turning, bed evaluation, pressure relief, nutritional assessment, and incontinence care.
Lyder, C. H., & Ayello, E. A. (2008). Pressure ulcers: a patient safety issue.
Paciella, M. E. (2017). Bundle up to prevent pressure ulcers. Am Nurse Today, 4(4), 1-5.
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