Pressure Ulcer Prevention
Capstone Project Milestone # 4: Pressure Ulcer Prevention
Pressure ulcers continue to be a prevalent issue in the health care system and causes “pain, slow recovery from morbid conditions, infection and death” (Kwong, Pang, Aboo, & Law, 2009, p. 2609). In the field of nursing turning and repositioning patients is a well-known nursing intervention to prevent development of pressure ulcers. However, many hospitals and facilities still neglect to apply this as a standard policy. This gives room for nurses and nursing aides to overlook the importance of this intervention resulting in increased pressure ulcer development. The purpose of turning and repositioning patients is to prevent oxygen deprivation to skin tissues caused by continuous pressure. The question then becomes whether to standardize policy for patients with a Braden score of less than sixteen to be scheduled for a turn and reposition every two hours to decrease risk of new pressure ulcer development.
Step 1: Assess the Need for Change in Practice
Currently at GH Care and Rehab facility, there is no standardized policy on determining when a patient needs an order to be turned and repositioned every two hours. When a patient first arrives at the facility, the admission nurses do a head to toe skin assessment along with checking Braden scores for each patient. Depending on the nurse carrying out the admission process, some order turn and reposition every two hours if the Braden score is lower than 14, while others write no orders. The main purpose of the Braden scale is to use as a predictive measuring tool for pressure ulcer. However, since there is no standard policy, the nurses neglect to order appropriate nursing intervention until a pressure ulcer has already started to develop.
According to the National Pressure Ulcer Advisory Panel (NPUAP), the occurrence of pressure ulcers range from 2.3% to 28% in long-term care facilities