Pressure ulcers also called bedsores are injuries to the underlying tissue and the skin as a result of prolonged pressure on the skin especially on the skin that covers the bony areas of the body such as the hips
Pressure ulcers also called bedsores are injuries to the underlying tissue and the skin as a result of prolonged pressure on the skin especially on the skin that covers the bony areas of the body such as the hips, tailbone, ankles and hips (Ayello & Baranoski & Cuddigan & Harris, 2015). This condition occurs to patients in critical conditions which limit their mobility since they are bed ridden; pressure ulcers is characterized with unusual change in skin color, swelling of the skin, pus-like draining, skin temperature of the body varying at the same time and formation of tender areas (Westcott & Welding, 2017).
These pressure ulcers are caused by three primary factors; this factors result of pressure on the skin limiting blood flow to the skin making the skin vulnerable to sores. The factors are: Pressure; pressure applied at a part of the body limits blood flow into tissues leading to damage of the tissues. Friction; this occurs when the clothing or bedding rub against the skin making the skin vulnerable to injury especially moist skin. Shear; this is the position of the body and the bed, for example in s wrongly inclined bed, the patient can slide to a lower position if the head area is lifted high; the moving of the tailbone, the skin over the bone might remain in place thus pulling in the opposite direction; this causes sores (Ayello & Baranoski & Cuddigan & Harris, 2015).
As of 2016, the number of adults in the United States who were affected by pressure ulcers was around 2 million and costing the patient close to $70, 000 per ulcer and costing the federal government 12 billion each year (Chitambira & Evans, 2018). The use of pressure redistributing support surfaces has not been effective alone but the inclusion of turning and reposition after every 2 – 4 hours greatly reduced pressure ulcer. This paper will look into the prevention of pressure ulcers using pressure redistributing support surfaces and repositioning every 2-4 hours; below is a PICOT statement of the clinical issue and the best way to prevent and reduce pressure ulcers. PICOT stands for Population, Intervention, Comparison, Outcome and Time.
Population: Critically ill patient bed ridden in the hospital
Intervention: Turning and repositioning of the patient after 2-4 hours
Comparison: Pressure redistributing support surfaces
Outcome: Prevention of pressure ulcers
Time: Patients will be observed in a period of 1 month
PICOT question: In critically hospitalized patients, how does repositioning and turning of the patient every 2-4 hours compare to the use of pressure redistributing support surfaces in the prevention of pressure ulcers?
The research commenced with the selection of 6 articles concerning the topic of discussion, pressure ulcers; the articles were specifically talking about pressure ulcers prevention through turning or repositioning and through the pressure redistribution support surfaces. The articles are rated as good qualitative and quantitative resources suiting the study.
Another source of information was interviewing a relative who works in Washington hospital in the cardiovascular unit who testified that they used mostly air pressure mattresses but for the patients who are very likely to develop skin break down, turning and repositioning after every 2-4 hours is preferred to other practices.
Turning and Repositioning
The sources used in the research indicated that there was minimal significant data on the effectiveness of Turning and Repositioning in the prevention of pressure ulcers (Gillespie & Chaboyer & McInnes & Kent & Whitty & Thalib, 2014); the resources stated that Turning and Repositioning did not reduce the rate of pressure ulcers but that does not mean that it is not to be considered (Chitambira & Evans, 2018); it is actually a fruitful practiced when combined with other treatment options. Further findings are needed to validate the effectiveness of Turning and Repositioning after every 2-4 hours as a preventive measure for pressure ulcers.
Pressure Redistributing Support Surfaces PRSS
Pressure Redistributive Support Surfaces did not provide significantly statistical evidence to prevent pressure ulcers but can effectively decrease the amount of prospective pressure ulcers. The use of Pressure Redistributing Support Surfaces acts as a protective factor against ulcer onset but it is an inconsistent measure for prevention of the pressure ulcers (Westcott & Welding, 2017). There is limited proof for the effectiveness of Pressure Redistributing Support Surfaces but studies have confirmed that in adults, there is an improvement in healing when the PRSS is used (Gillespie & Chaboyer & McInnes & Kent & Whitty & Thalib, 2014).
Comparing and Contrasting Turning and Repositioning with Pressure Redistribution Support Surfaces
There is the need for a further research on the evidence to prove the intervention and its comparison do actually significantly have an effect in the prevention of pressure ulcers. The one month evaluation of the two prevention is not ample to generalize the findings as more data is needed which will require more patients used and over a long period of time like a year or two. More evidence is also needed for the support of PRSS as a prospective method for the prevention of pressure ulcers; despite PRSS being a major reducer of pressure ulcers in surgery related injuries (Bredesen & Bjøro & Gunningberg & Hofoss, 2015), there is more needed to actually prove the method is effective. Turning and Repositioning is a must do prevention method since it reduces the cause of ulcers but the method alone cannot prevent or reduce the pressure ulcers completely (Dealey & Brindle & Black & Alves & Santamaria & Call & Clark, 2015). However, there is light at the end of the tunnel as patients who have been subjected to both PRSS and Turning Repositioning have shown improvement in the outcome of the interventions; the two interventions are mostly used together in most health facilities coupled with other interventions since the combination has proven to be effective in the reduction of pressure ulcers.
Evidence Based Recommendation
From the research, it is evident that the use of the two interventions prove fruitful compared to each intervention working alone; therefore, it is recommended that the two interventions are employed together and also, more research is required on the two interventions and other interventions that can be coupled up to increase the rate of pressure ulcer reduction (Dealey & Brindle & Black & Alves & Santamaria & Call & Clark, 2015).