Introduction
HAPU is a soft tissue decay process associated with prolonged pressure on a specific area. In modern medicine, the development of pressure sores is associated with limited mobility due to diseases, insufficient care, hygiene, and impaired sensitivity. With pressure sores, the integrity of tissues is disturbed, and wounds occur.
Left untreated, the fatty tissue, muscles, and bones are involved in the pathological process. Patients often face a widespread problem because their skin is vulnerable during a prolonged stay in a prone position. The treatment and prevention of HAPU should be implemented in each hospital, whose internal environment is built on the principle of comprehending human beings as a core value.
Approaches to Prevent and Control HAPU Development
Pressure relief is one of the main ways to prevent HAPU or reduce its prevalence. It is achieved by carefully positioning the patient and using protective devices and anti-decubitus blankets. However, studies show that about 30 percent of the medical staff neglect to relieve pressure or perform this task less frequently than necessary (Díaz-Caro & García Gómez-Heras, 2020). Changing positions repeatedly and choosing a comfortable one is an essential treatment method.
Furthermore, a written schedule can be used to select and document position changes. Bedridden patients should be turned at least every 2 hours and placed at a 30° angle to the mattress on their side to avoid direct pressure on the femoral trochanter (Floyd et al., 2021). To prevent the effects of shear forces, the elevation of the head end of the bed should be minimal. Moreover, elevators or linen bedding should be used instead of dragging the patient when changing the patient’s position to avoid excessive friction. It leads to a significant reduction in pressure on the patient’s skin and to a deceleration of tissue death, even after a considerable time in the supine position.
Moreover, therapeutic mattresses for bedridden patients can be replaced to reduce pressure. Anti-decubitus covers are classified based on whether or not they require electricity to operate. Unlike dynamic covers, static covers do not require electricity (Floyd et al., 2021). Although dynamic covers are generally recommended for more severe bedsores, there is no conclusive evidence of the advantage of dynamic covers over static covers. Static covers contain air, foam, gel, and water interlayers, and mattresses and cellular mattresses have not shown benefits (Cabrejo et al., 2019).
Static coatings generally increase support surface area and reduce pressure and shear forces. Clinical trials and economic analyses published between 2007 and 2021 involving 3,941 people confirm the critical role of body position changes (Díaz-Caro & García Gómez-Heras, 2020). An interval of two hours is the most acceptable to reduce the severity of hospital ulcers, in addition to the role of the reclining position. Those patients to whom this intervention was applied less frequently had a much higher degree of bedsores, which were already evident from the first days in the hospital.
Conclusion
Therefore, a change of pressure from one part of the body to another can prevent or reduce the extent of the problem. Changing positioning is one strategy used along with other methods to prevent bedsores from developing. Position changes involve moving the person to different positions to redistribute pressure from one body part to another. This intervention is effective and helps prevent HAPU development in patients for whom this method is used systematically. Individuals in the same body position will experience problems much more quickly, and soft tissue death is often unavoidable.
References
Cabrejo, R., Ndon, S., Saberski, E., Chuang, C., & Hsia, H. C. (2019). Significance of friction and shear in the prevention of contemporary hospital-acquired pressure ulcers. Plastic and Reconstructive Surgery Global Open, 7(4). Web.
Díaz-Caro, I., & García Gómez-Heras, S. (2020). Incidence of hospital-acquired pressure ulcers in patients with” minimal risk” according to the” Norton-MI” scale. PLoS One, 15(1), 52. Web.
Floyd, N. A., Dominguez-Cancino, K. A., Butler, L. G., Rivera-Lozada, O., Leyva-Moral, J. M., & Palmieri, P. A. (2021). The effectiveness of care bundles including the braden scale for preventing hospital acquired pressure ulcers in older adults hospitalized in icus: A Systematic review. The Open Nursing Journal, 15(1). Web.