Laura Saldivar
Laura Saldivar
The development of pressure ulcers, or bed sores, remains one of the biggest problems in nursing care for immobile patients today (Sharp, Schulz, & McLaws, 2019). It is a definite problem in the health care system, which affects both patients, their families, medical staff and healthcare facilities. For the patient, they may experience severe pain, helplessness, as well as financial difficulties from increased cost of treatment (Gill, 2015). Unfortunately, medical staff may find great challenges to prevent these skin issues, as well and treat them after they have occurred. Pressure ulcers are also referred to as bed sores, skin tears, or deep tissue injuries that happen due to constant pressure, shearing, or friction for prolonged periods of time (Gillespie, Chaboyer, McInnes, Kent, & Whitty, 2014). These wounds are common in the geriatric population and immobile patients who spend a great amount of time laying or sitting down (Sharp, Schulz, & McLaws, 2019).
The decreased physical movement, immobility and inability to turn are the main cause of pressure ulcers, there is a variety of strategies practiced by nursing staff to prevent them from occurring (Gillespie, Chaboyer, McInnes, Kent, & Whitty, 2014). Most hospital protocols enforce staff to manually turn the patient which is the most common mode of prevention. By shifting a patient’s position in bed every 2 hours, it promotes blood flow, which is necessary for healthy skin (MedlinePlus, 2017). Due to lack of turning, blood and waste tend to pool in the tissues which inhibits nutrient exchange from healthy tissues. Frequently turning a patient helps the release of waste build up and promotes healthy skin (Hess, 2009). Every hospital or healthcare facility has their own scheduled repositioning protocol. Although, intensive care units as well as long term care facilities whose population has decreased mobility, the standard time is two hours (John Maynard, 2015). Unfortunately, staff tends to be unaware of the turn Q2 rules or fails to perform the task which has led to this becoming one of the largest occurrences of hospital acquired injuries or HAI’s (Fletcher, 2017).
References
Cooper, K. L. (2013). Evidence-Based Prevention of Pressure Ulcers in the Intensive Care Unit. Critical Care Nurse, 57-66.
Fletcher, J. (2017). Reposition Patients Effectively to Prevent Pressure Ulcers. Wounds International, 7-10.
Gill, E. C. (2015). Reducing hospital acquired pressure ulcers in intensive care. Biomedical Journal, doi: 10.1136/bmjquality.u205599.w3015.
Gillespie, B. M., Chaboyer, W. P., McInnes, E., Kent, B., & Whitty, J. A. (2014). Repositioning for pressure ulcer prevention in adults. Cochrane Systematic Review.
Hess, C. T. (2009). Take Steps to Prevent Pressure Ulcers. Nursing, 61.
John Maynard. (2015, November 18). Move Every Two: Repositioning Patients to Prevent Pressure Injuries. Retrieved from Shield Healthcare Community: http://www.shieldhealthcare.com/community/popular/2015/11/18/move-every-two-repositioning-patients-to-prevent-pressure-ulcers/
MedlinePlus. (2017, November 15). Turning patients over in bed. Retrieved from MedlinePlus.Gov: https://medlineplus.gov/ency/patientinstructions/000426.htm
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