Thursday, September 12, 2019

Pressure Ulcer Prevention Using Skin Bundle Research Paper

Pressure Ulcer Prevention Using Skin Bundle - Research Paper Example Once the skin succumbs to bacteria or sustains injuries from friction and shear, healing takes longer because reduced flow of blood brings nutrients and removes wastes more slowly. Ischemia due to unrelieved pressure is usually observed in the elderly, malnourished patients, patients reduced to immobility because of their medical condition, fecal incontinence, and patients under less than conscious condition (Mauk 2009, p. 501). Pressure Ulcers: Incidence, Prevalence and Prevention In 2004, the National Home Survey reported that for every 10 residents in nursing homes all over the United States, 11% have succumbed to pressure ulcers with stage 2 pressure ulcer as the most common (see Fig. 2). Both whites and non-whites had equal percentage with the males edging the females at 13% and 10%, respectively (Park-Lee & Caffrey 2009). In 2007, the Centers for Medicare and Medicaid Services reported some 257,412 preventable pressure ulcers as secondary diagnoses at cost averaging at $43,180 for every stay in the hospital. This compelled Medicare to give up shouldering pressure ulcer costs so as to encourage its prevention (Mauk 2009, p. 501). The Institute for Healthcare Improvement has recommended a set of simple interventions collectively known as ‘bundle’ for pressure ulcers prevention in 2003. Hospitals are encouraged to develop their own â€Å"bundle† in approaching pressure ulcer prevention (Paciella 2009, p. 43). The SKIN bundle, which is an acronym for Surface, Keep Moving, Incontinence and Nutrition, was developed by the Ascension Health facilities in 2004. In the succeeding pages a sample of change in practice program is outlined for a fictitious hospital ward called HTMC for the prevention of pressure ulcer using the SKIN bundle. Change in Practice for Pressure Ulcer Prevention Name of Ward (fictitious): East Wing 13 Holy Trinity Medical Center (HTMC) Demographics: 24-bed unit, 10 private and 14 semi-private; Staff is composed of ARNP, RN s, patient care technicians, nutritionists, therapists, and others Scope of Service: Patients in the ward are admitted for the following conditions: strokes and seizures, multiple sclerosis and other diseases that make them prone to develop pressure ulcers. A. ASSESSMENT In the first quarter of 2010, the East Wing 13 of the HTMC had reported 27% incidence of pressure ulcer cases compared to the National Database of Nursing Quality Indicators or NDNQI’s report of 3.8%, for Stage I-IV and 2.7%, for Stage II-IV for the year 2010. This is not a good development, not only because the ward’s statistic paled in comparison with the NDNQI’s but also because the CMS has stopped shouldering costs for pressure ulcers that are acquired in the ACFs. B. LINK The US DHHS recommended several measures in the prevention and care of pressure ulcers. These recommendations can be used by the East Wing 13 to reduce the percentage of pressure ulcer incidence. They include the following : skin inspection of patients at least once daily; skin cleansing in accordance to the needs of each patient; skin care such as moisturizers for dry skin and less exposure to humidity and cold; moisture due to incontinence, perspiration, or wound

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