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Pressure Ulcers in the Elderly
Gifty Appiah
Dr. Judi Kuric
DNP Project
Final Premise
DNP Project Question
Will Every Two Hourly Turning and Positioning Decrease Pressure Ulcers in the Elderly Bed Bound Population in Nursing Home.
Will Every Two Hourly Turning and Positioning Decrease the Pressure Ulcers in the Elderly Bed Bound Population in Nursing Homes.
Pressure ulcers are a common cause of immobility among the elderly, which results in immense pain, suffering, and substantial costs with charges because of increased length of stay in the nursing homes. Prior studies suggest that patients who receive care in accordance to evidence-based guidelines are not at risk of developing pressure ulcers. However, the empirical evidence on the effectiveness of the measures is inadequate. Nevertheless, frequent manual repositioning of patients is a firmly established standard of care for the elderly; although there has been no much evidence on the same, experts suggest that it is effective. There are several risk factors for pressure ulcers in the elderly:
Intrinsic
Extrinsic
Aging
Pressure
Chronic Disease
Friction
Impaired Mobility
Shearing
Limited Activity
Limited Activity
Fecal Incontinence
Moisture
Malnutrition
Sensory Impairment
Objectives
Pressure ulcers are common phenomenal in the elderly, and immobility is among the adverse effects associated with the condition. Although numerous nursing...
Therefore, this review aims to establish whether two hourly manual repositioning is effective in preventing pressure ulcers among the elderly. This being said, there is also research that shows simply turning the patient is not enough, by itself, to completely remove the threat of pressure ulcers, and must sometimes be combined with other methods in order to enhance efficacy.
Review methods
This review relied on scholarly reviewed articles reporting on prevention measures in relation to pressure ulcers among the elderly. In addition, the papers selected for this review had to show or illustrate how the prevention strategy was effective in the prevention of ulcers; however, this review did not impose a restriction on studies that showed other prevention measures other than two hourly manual repositioning.
Results
Gray and Krapfl (2008) systematically review suggests that two hourly manual repositioning, when combined with a proper pressure redistribution surface is effective in prevention of Pus among the elderly. A randomized trial by Grypdonck, et al., (2005) found out that two hourly repositioning reduced the incidence of PUs. However, a cohort study by Rich, et al., (2011) found out that two hourly repositioning did not reduce the incidence of PUs among the elderly. An observational study by Krishnagopalan, et al. (2002) found out that two hourly repositioning had the capacity to reduce ulcers. In addition, a cohort study by Rich et al. (2011) suggests…
One important aspect of nursing home living is that most of the time the people living there are helpless to accomplish many tasks that are part of everyday living. The employees are trained (for the most part) and as one study found it is "important to assess whether nursing staff levels and skills are meeting nursing home resident care needs" (Zhang, Unruh, Wan, 2013, p. 290). For example, incontinence is a significant risk factor for skin breakdown. The moisture changes the chemical balance of the skin, and often without adequate ventilation and care, a route for bacterial infection. In either case, pressure on the wound area, increased bacteria and moisture, all contribute to the lesions becoming rather serious (Gefen, 2008).
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