Management of Pressure Ulcers in Non-Ambulatory Patients

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Table of Contents

Aim
Problem
Importance
Expected Outcomes
Measures
Risks/Barriers
Stakeholders
Reference

Aim

To significantly reduce the number of non-ambulatory patients over 25 years of age getting pressure ulcers. To enhance nursing care and education regarding bedsores. This will be achieved within six months.

Problem

According to the Agency for Healthcare Research and Quality (2014), approximately 2.5 million people develop bedsores annually, and “about 60,000 patients die as a direct result of a pressure ulcer each year” (para. 1.1). This problem affects many persons and especially non-ambulatory adults due to their limited mobility and abilities in general. In many cases, nurses lack the required resources, time, or education to address the problem with each patient, or the existing interventions can appear ineffective.

Importance

Bedsores are painful injuries to the skin caused by prolonged pressure from sitting in a wheelchair or lying in bed. These pressure ulcers cause serious discomfort and can make patients depressed. The project will improve patient outcomes, decreasing the number of non-ambulatory adults receiving pressure injuries. Since the latter is sometimes the direct cause of death or severe complications, preventing bedsores in most patients will show a positive healthcare tendency and reduce costs: “pressure ulcers cost $9.1-$11.6 billion per year in the US” (AHRQ, 2014, para. 1.1). Specific steps and interventions within the project will make patients healthier and safer, which is the primary goal of our clinic.

Expected Outcomes

All nurses are educated about the risks of bedsores and the measures they must take to prevent them.
Head-to-toe skin assessments are conducted daily.
Risk assessment is documented daily.
Reduce deaths due to bedsores to zero in six months.
Reduce the occurrence of pressure ulcers in non-ambulatory patients by up to 2% in six months.

Measures

Number of nurses following the new intervention and guidelines.
Number of non-ambulatory patients developing bedsores.
Percentage of patients dying from pressure ulcers.
Number of assessments performed.

Risks/Barriers

The primary barrier our clinic anticipates is that there will still be a lack of developed guidelines and policies addressing the correct care for patients who are at risk of developing bedsores. Second, some nurses may be against this intervention due to their personal reasons. Third, heavy workload and shortage of time and equipment may also prevent our staff from following the policies correctly. In some cases, there may be resistance from patients who do not understand that a full examination or turning every few hours is necessary to avoid pressure ulcers. Finally, ensuring that the nurses actually conduct daily assessments of all patients will also be challenging.

Stakeholders

The key stakeholders are non-ambulatory patients and their families, nurses, and our clinic’s other medical staff. We will utilize a multidisciplinary approach and seek feedback from patients and their relatives.

Reference

Agency for Healthcare Research and Quality. (2014). Preventing pressure ulcers in hospitals. AHRQ.

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