The problem of interest is pressure ulcers among elderly and critically ill patients. Pressure ulcers are injuries to pressure areas caused by prolonged exposure to pressure, primarily due to a lack of turning. Critically ill and elderly patients have serious musculoskeletal issues, are mostly unconscious, and face coordination problems. Studies show that elderly and critically ill patients report the highest prevalence of pressure ulcers and are prone to severe pressure ulcers. Pressure ulcers are prone to infections, and such pressure ulcers take long periods to heal due to the decreased blood supply to the skin. Pressure ulcers can progress to gangrene and affect bones such as the sacrum and calcaneus (heel bone) (Bazaliński et al., 2018). According to Bazaliński et al. (2018), infections to bone, skin, and muscle secondary to pressure ulcers are always serious and carry an increased risk of patient death.
Patient turning and routine skin care are the standard procedures in patient care. Nurses turn patients, wash, massage, and apply skin care products (Mitchell et al., 2018). The procedure can be effective when carried out routinely. However, patient turning is difficult, especially due to the global nursing staff shortage, and patient conditions such as injuries limit the procedure’s application. Pressure ulcer prevalence is a safety and care quality indicator in healthcare institutions showing the importance of managing it. Pressure ulcers thus pose a threat to patient safety and patient care outcomes hence the need for care interventions that reduce pressure ulcers. The goal is to relieve pressure off the vulnerable areas and promote proper circulation in pressure areas to prevent pressure ulcer development.
The PICOT question of interest is “Among critically ill and elderly patients, does using ripple mattresses compared to usual care prevent pressure ulcers and improve their management?”
Sachs et al. (2018) evaluated how nurses prevent pressure ulcers for patients undergoing subacute rehabilitation after severe brain injury. The article aimed to observe the healthcare professional’s intent to prevent pressure ulcers. The article adds to existing knowledge and helps determine gaps in care delivery and patient safety. It points out the factors affecting pressure ulcers; “mobility, perfusion, skin/pressure ulcer status, skin hydration, age, hematological measures, nutrition, and general health” (Sachs et al., 2018). The study shows a gap between national guidelines in preventing pressure ulcers and implementing these interventions. A major research question in this study was to determine professionals’ utilization of evidence-based strategies recommended by the relevant bodies and institution leadership.
Gasper et al. (2018) studied the perceptions of 11 Portuguese nurses’ stakeholders regarding pressure ulcer prevention practice and reality in the hospital setting. The study focused on understanding how nurses perceive pressure prevention. The themes evaluated were PU risk assessment, monitoring, profiles, and effective interventions to improve patient safety. The research question was to determine if nursing knowledge and practices were adequate to prevent pressure ulcers. The article evaluated current professional and institutional practices that aim to improve care delivery. The propeller of the study was the constantly high prevalence of pressure ulcers in healthcare settings, which indicates poor healthcare service delivery. The study identifies that healthcare institutions and relevant bodies develop evidence-based strategies, but the prevalence of pressure ulcers remains high, hence the need to evaluate the reasons. The article is significant to nursing because it unearths the major causes of the underutilization of evidence-based strategies developed.
Sachs et al. (2018) support the problem by identifying one of the most common problems in healthcare settings that negatively impact patient safety and care quality. The article also shows the importance of caring for critical care patients while ensuring they do not develop pressure ulcers. It also shows that pressure ulcers are expensive healthcare events and are prevalent in primary and secondary care. The articles show that severe brain injury affects consciousness and subsequent mobility, and patients require assistance with turning to prevent them from developing pressure ulcers. The study identifies that the problem can be managed through professional evaluation/ assessment, c
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