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New Practice Approaches Through Policy
One of the major current concerns in health care is the rapidly aging nature of the populations in Western societies today. This is, in general, attributed to developments in medical science and better information regarding personal health choices and activities. Despite this, however, it is also true that aging seldom brings with it a glowing sense of health. While many people today age better than ever before in human history, the elderly also tend to suffer from an increasing number of conditions, some of which leave them bed bound. Many of these bed bound residents, in addition to their initial conditions, also suffer related ailments such as pressure ulcers. These create not only great physical discomfort and emotional stress, but also great burdens on the health care system in terms of treating such ulcers. For this reason, it is suggested that policies should be created and/or modified to help nurses implement prevention strategies for bed bound residents in care homes (Mackie and Dunnery, 2008).
Niezgoda and Mendez-Eastman (2006) confirm that pressure ulcers create very high costs in terms of both the financial aspect and non-monetary costs. In United States hospitals, for example, 1.6 million pressure ulcers result in an estimated annual cost of $2.2 to $3.6 billion. The authors point out that this estimate is probably on the low side, as Stage III and Stage IV pressure ulcers require even more costly interventions. In addition, the emotional costs are significant. The authors note that there...
Persons with pressure ulcers often experience not only physical discomfort, but also a sense of loss in terms of control and independence. There is also a tendency towards isolation when pressure ulcers occur.
The above-mentioned costs, especially in nursing homes, where care should be resident-centered, must be regarded as unacceptable, especially by nursing staff employed to care for residents. There are, however, significant barriers to implementing significant strategies to help residents at risk of suffering pressure ulcers in nursing homes.
One significant barrier is significant and consistent research regarding pressure ulcers. While the causes and treatments of ulcers have received significant attention, as suggested by Niezgoda and Mendez-Eastman (2006), there is a great lack of consistency in the research regarding the effectiveness of prevention strategies.
One significant prevention strategy is frequent repositioning. This is a commonly-cited method to help bed bound persons relieve pressure points where ulcers are likely to develop. As proponents of this method, Mackie and Dunnery (2008) suggest an educational strategy, in which patients who are able to do so are taught to reposition themselves. Such a strategy relieves the pressure on nurses to provide regular (for example 2-hourly) repositioning. This would also relieve the burden on the already strained health care resources available to nursing homes.
A study done by Rich et al. (2011),…
References
Leonard, R. (2001, Spring). Policy Considerations for Nursing Home Quality Improvement. Harvard Health Policy Review 2(1). Retrieved from: http://www.hcs.harvard.edu/~epihc/currentissue/spring2001/leonard.html
Mackie, S. And Dunnery, P. (2008). Clinical Policy: Pressure Ulcer Prevention and Care for Adults in Hospital. Retrieved from: http://www.nhstayside.scot.nhs.uk/about_nhstay/commitees/08_iaq/27012009/docs_024483.pdf
Niezgoda, J.A. And Mendez-Eastman, S. (2006, Feb.). The Effective Management of Pressure Ulcers. Advances in Skin & Wound Care: The Journal for Prevention and Healing 19(1). Retrieved from: http://www.nursingcenter.com/lnc/JournalArticle?Article_ID=636557&Journal_ID=54015&Issue_ID=636556
Rich, S.E., Margolis, D., Shardell, M., Hawkes, W.G., Miller, R.R., Amr, S., and Baumgarten, M. (2011, Jan.). Frequent manual repositioning and incidence of pressure ulcers among bedbound elderly hip fracture patients. Wound Repair Regen 19(1). Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3059225/
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