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The practice issues of pressure ulcers

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Introduction

The practice issues of Pressure Ulcers The aim of this assignment is to define the meaning of pressure ulcers, and to explore the causes, and aims of preventing them. Pressure sore -"A decubitus ulcer; a bedsore. Ulceration of the skin due to pressure, which causes interference with the blood supply to the area" ( Weller 2005) Bed sore (decubitus ulcer, pressure sore) -" An ulcerated area of the skin caused by the continuous pressure on part of the body in a bedridden patient" (Fergusson and Stibbs 2003) Nurses and physicians use many terms for a pressure ulcer. Allerescu and Allerescu (1992) reported that these terms include decubitus, decubiti, pressure ulcer, pressure sore, bedsore and pressure necrosis. They believe the term pressure ulcer bests describe the aetiology. (Davies 1994). A pressure ulcer can also be described as "damage to the skin and underlying tissue" (Wrightington, Wigan and Leigh NHS Trust 2002). Morison (1989) explains that a pressure ulcer is caused by a prolonged unrelieved pressure, however Hibbs (1988) and Morison (1989) describe that shearing and friction are also known to cause the type of tissue damage associated with pressure sores. (Davies 1994). Wrightington, Wigan and Leigh NHS Trust (2002) advise a patient sliding down a chair or in bed causing slight friction can cause and worsen minor pressure ulcers. They explain that pressure on the skin, when unrelieved, squeezes blood vessels which supply the skin with oxygen and nutrients. ...read more.

Middle

(Verner 2006/2007) Preventing pressure ulcers is very complex, dependant on the requirements of the individual. Mobility of a patient plays a great part in preventing these sores, as we have already identified that they are caused by a "prolonged unrelieved pressure." (Morison 1989) If a patient is mobile or has a degree of mobility using walking aids, pressure ulcers are much less likely to present themselves. Where a client is bedridden, the nursing and multidisciplinary team must relieve the pressure for the patient. This is very important as the patient is unable to do this for themselves. Nurses can use techniques such as changing body position at least two hourly, using types of elbow, hip and heel protectors, using sheets that are clean, without creases and avoiding synthetic materials which are more likely to make the skin sticky and hot. (Department of Health 1994) A patient presenting a pressure ulcer requires careful nursing care to prevent gangrene and it is essential that the area is kept dry and clean. The position of the patient should be frequently changed to prevent the high risk areas, such as the buttocks, heels and elbows from being affected. (Fergusson and Stibbs 2003) Using the right equipment is especially important when caring for patients susceptible to pressure ulcers, and a doctor, nurse or occupational therapist can advise on the wide range of support equipment available. The equipment includes mattress covers, special beds, and pressure relieving mattresses and cushions. ...read more.

Conclusion

Our patients come into hospital to be treated and for us to help them recover, they do not wish to leave hospital with a life threatening condition that could have been prevented. Knowledge is the key to giving patients the best care we can provide. Reference List Allman, R.M., Goode, P.S., Patrick, M.M., Burst, N and Bartolucci, A.A. (1995) Pressure ulcer risk factors among hospitalized patients with activity limitation. The Journal of the American Medical Association. Vol 273, pages 865-870. Davies, K. (1994) Pressure sores: aetiology, risk factors and assessment scales. British Journal of Nursing. Vol 3, No.6, pages 256-259. Department of Health (1994) Your guide to pressure sores. UK: Health Literature Fergusson, R and Stibbs, A. (2003) Oxford Minidictionary for Nurses. 5th Edition, page 66. Oxford: Oxford University Press. Gebhardt, K. (1995) Clinical: What causes pressure sores? Nursing Standard. Vol 9, page 31. Reddy, M., Sudeep,G., and Rochon, P. (2006) Preventing Pressure Sores: A systematic review. Vol 296, pages 974-984. Richardson, R. (2008) Clinical Skills for Student Nurses. Pages195-213. UK: Reflect Press Ltd. Roland, L.P. and Merritt, H.H. (2005) Merritts Neurology. 11th Edition. Philadelphia, USA: Lippincott, Williams and Wilkins. Verner, Y. (Dec 2006/Jan 2007) Building profiles to create individual care. Kai Tiaki Nursing. Vol 12, page 11. Waterlow, J. (2005) 'Waterlow pressure ulcer prevention/treatment policy'. Waterlow Score Card, available at Judy-Waterlow.co.uk. Last accessed 14/07/2008. [online at: http://www.judy-waterlow.co.uk/waterlow_score.htm] Weller, B.F. (2005) Bailliere's Nurses' Dictionary. 24th Edition, page 315. London: Elsevier. Wrightington, Wigan and Leigh NHS Trust (2002) Tissue Viability, Pressure Ulcer Prevention. Wigan and Leigh: Clinical Support Services. ...read more.

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