Pressure ulcers are injuries that occur on the skin of an individual and the underlying tissues and are caused by increased and sustained pressure on the affected area. This pressure often interrupts blood flow resulting in decreased supply of oxygen and nutrients to the affected region resulting in ulceration (Kottner et al., 2019). Lewin’s Change Theory involves three fundamental steps; unfreezing, changing, and refreezing. The theory indicates that for change to occur, there is a need to recognize the need for change and a subsequent move to the new desired level of behavior. The final step of change, according to the theory, is the solidification of the new behaviors and norms (Lawery, 2020). This paper discusses the application of Lewin’s Change Theory in the prevention of pressure ulcers.
According to Lewin’s Change Theory, the primary phase in preventing pressure ulcers is recognizing the existence of the problem and the class of patients facing the problem. Pressure ulcers are quite common among hospitalized patients who sit or lie in one position for long durations. Additionally, pressure ulcers are usually slow to heal and tend to recur; thus, preventing them is quite essential. Patients with a high likelihood of getting pressure ulcers include extremely weak patients and paralyzed or unconscious patients.
The next phase of change is the identification of appropriate interventions to prevent the development of pressure ulcers in patients. Listening to patients’ complaints as they mention the sore areas is vital. This prompts a care practitioner to reposition the patients regularly. Regular repositioning (every two hours) is also applicable for unconscious patients (Boyko et al., 2018). Training of nurses and caregivers on how frequently repositioning should be done vital. Another intervention is purchasing and using pressure-relieving mattresses (e.g., alternating pressure mattresses), sheepskin mattresses, pillows (to elevate areas like heels), and support surfaces (Kottner et al., 2019). The identified interventions can then be implemented on the vulnerable populations while avoiding (and eliminating) all the other non-valuable behaviors, e.g., long-term patient repositioning.
The last phase involves the solidification of the interventions. This can be done by regularly monitoring how the care practitioners implement the interventions, monitoring pressure ulcer cases, and regularly training nurses on preventing pressure ulcers. Additionally, getting feedback and modification of interventions also helps solidify the implemented interventions. The management should work with the care practitioners to ensure that the interventions become a habit.
References
Boyko, T. V., Longaker, M. T., & Yang, G. P. (2018). Review of the current management of pressure ulcers. Advances in Wound Care, 7(2), 57-67. Web.
Kottner, J., Cuddigan, J., Carville, K., Balzer, K., Berlowitz, D., Law, S., Litchford, M., Mitchell, P., Moore, Z., Pittman, J., Sigaudo-Roussel, D., Yee, C. Y., & Haesler, E. (2019). Prevention and treatment of pressure ulcers/injuries: The protocol for the second update of the international clinical practice guideline 2019. Journal of Tissue Viability, 28(2), 51–58. Web.
Lawery, L. (2020). Protecting the integument: Changing nursing practice to prevent pressure injuries. [Doctor of Nursing Practice thesis, Jacksonville State University]. JSU Digital Commons. Web.