Pressure Ulcers

 

Introduction

Pressure ulcers are confined areas of tissue damage that are generated by pressure to the skin. They appear on the skin that protects the bony areas of the skin. They mostly occur to individuals that sit down for long hours. Pressure ulcers should be handled with care, compassion, and dedication to the patients. Pressure ulcers significantly affect a patient’s quality of life, morbidity, and mortality.

Pressure ulcers are an issue because according to research, the prevalence of the condition is in many countries including Europe and the United States which is in high rates. Age, poor nutrition, obesity, and poor posture have increased the rate at which people are getting pressure ulcers. They tend to be painful, weakening and difficult to heal. They are connected to psychological, physical, and social issues. Prevention and treatment costs are very expensive for pressure ulcers and research shows that it is the third most expensive condition after cardiovascular illnesses and cancer (Agrawal and Chauhan 2019). Pressure ulcers patients have high mortality rates and admission and re-admission to the hospital are also at high rates. Pressure ulcers lead to a rapid increase becoming a healthcare burden and also causing financial constraints to the patients.

 The clinical intervention that is being used for pressure ulcers consists of using support surface systems. The support systems are developed to help prevent pressure ulcers and they have been designed with different techniques that work towards reducing pressure. The support systems reduce pressure by sharing the weight over the maximum area of the body. They alter the pressure below the body to minimize the period of the pressure that is applied. The pressure support surfaces work towards reducing the immensity of pressure in an individual and the support surface to avoid pressure ulcers. (McInnes, Jammali-Blasi, Bell-Syer, Dumville, & Cullum 2012). Some of these support surfaces are machine-like systems.

The total participants for this study were 16,285 where 53 random trials were identified. The records were identified by searching that was done through the database and were 184 . 11 additional records were identified through other sources. There were 195 records after duplicates were removed. 195 records were screened and 83 were excluded. The full-text articles evaluated for eligibility were 112 and full texts articles that were excluded with reasons were 59. 2 were excluded because of literature reviews, 8 because of incomplete data, 20 did not have a clinical outcome, 11 were not a trial, 9 had a different intervention and 9 did not meet other inclusion criteria. The total trial review was 53 and they took place in different arrangements (McInnes et al. 2012). The sample sizes were from participants who were followed up on a daily to yearly basis. The result evaluation took a similar period and was reported in 34 trials done daily or weekly.

Reports from 37 trials showed that participants' groups were similar regarding the predictive factors. 13 trials involved patients with preexisting pressure ulcers and 7 out of the trials involved the only ones with grade 1 pressure ulcers, 3 had grade 1 and 2 and 1 trial involved those with grade 4. For 2 trials, there was no clarity on the grade of pressure ulcer. For 14 trials, it did not clearly show if preexisting pressure ulcers were involved. Classification of the trials was assessed according to “high tech” and “low tech” gadgets and the other types of support surfaces (McInnes et al. 2012). 23 trials assessed the “low tech” pressure support surfaces. “High tech” support surfaces were assessed by 21 trials.

When quality foam hospital mattress and low-pressure support surfaces were compared, it showed that pressure ulcers were reduced when the foam alternative support surface was used. Several other products were used in opposition to the standard hospital mattresses and the patients with pressure ulcers that were perceived to be at increased risk were reduced. (McInnes et al. 2012). Alternative foam support surfaces showed that their pressure ulcers were reduced where people replaced fiber mattress to foam overlay. When the use of sheepskins which were low tech support surfaces was contrasted to quality care, for the people that used sheepskins there were reduced pressure ulcers. When body support was contrasted to quality care, pressure ulcers seemed to reduce (McInnes et al. 2012). Quite some products and support surface systems have a positive impact on the decline and prevention of pressure ulcers. Some of the support surfaces though have not shown clear ways of reducing or preventing pressure ulcers.

           Pressure ulcers that have been increasing with a high rate have been connected to the quality of health care. The rising-rate shows that there has been poor health care for pressure ulcers. This means that the findings in the research study are not being used. There has been a major limitation in the pressure ulcer studies which is the small sample size. It has been hard to compare a person’s hospital incidence rate at the national level. It has been a challenge for clinicians and lawmakers to know the impact of people’s particular clinical characteristics on the risk of creating pressure ulcers that are acquired in the hospital (Lyder, Wang, Metersky, Curry, Kliman, Verzier & Hunt 2012). Lack of enough samples to give more understanding of the pressure ulcers and this gives very little information about the people in the hospital or their improvement.

Conclusion

           Research on pressure ulcers has shown that its prevalence is high in certain countries which cause psychological, physical, and social issues to an individual. Pressure ulcers affect an individual quality of life and are mostly caused by age, poor nutrition, obesity, and poor posture. Clinical interventions that include support systems have been designed with different techniques working towards reducing pressure. In a research study, participants were used to determine the kind of support systems that work towards reducing pressure and how effective they are. In the study, the different trials showed the impact they had on pressure ulcers. Some of the trials were not clear on their impact in pressure ulcers and some proved that they should not be used at all. This condition has been connected to the quality of healthcare and the increased rates of the condition show that there is low-quality care for people with pressure ulcers. Due to the lack of enough sample sizes, there has been a limitation in the pressure ulcer studies making it difficult for patients to benefit in the prevention methods. This too has led to a lack of information about the people in the hospital due to pressure ulcers and their improvements or what more should be done for them to get better and quality healthcare.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

Agrawal, K., & Chauhan, N. (2012). Pressure ulcers: Back to the basics. Indian journal of plastic

surgery: official publication of the Association of Plastic Surgeons of India, 45(2), 244–254. https://doi.org/10.4103/0970-0358.101287References

Lyder H.C, Wang Y., Metersky M., Curry M., Kliman R., Verzier N.R. & Hunt D. R (2012)

Hospital-Acquired Pressure Ulcers: Results from the National Medicare Patient Safety

Monitoring System Study Journal compilation 60:1603–1608

McInnes E., Jammali-Blasi A., Bell-Syer S., Dumville J, & Cullum N. (2012) Preventing

pressure ulcers—Are pressure-redistributing support surfaces effective? A Cochrane

systematic review and meta-analysis, International Journal of Nursing Studies 49 (2012)

345–359