The understanding of the meaning of pressure ulcers is very paramount to the enabling of a better understating of the research at hand. Although several definitions have been proposed, a simple and widely applied one defines it as, localized damaged skin parts and/ or its underlying tissues that result from friction, shear and pressure, or sometimes may be caused by combination of these factors. It is a problem which develops when the blood flow within the capillaries connecting the skin and its underlying tissues are impeded through compression resulting into necrosis. Pressure ulcers have also been referred to using other many different words/ terms such as decubitus, decubitus sore, pressure sores and bedsores depending on organizations, geographical areas and academic levels. Importantly to know is when the health status of a person is compromised by any disease and ill condition, the blood flow pattern becomes prone to numerous risk factors, hence, both higher and lower pressures from the normal atmospheric one potentially affects its flow (Ayello and Braden, 2005).
For the first time, it has been noted that pressure ulcers are among the major health problems the world is grappling to deal with. In this connection, almost a decade back, there were approximately three thousand million plus old persons, suffering from pressure ulcers globally. Surprisingly and worriedly, the population number of adults affected by pressure ulcers has almost doubled after a decade (Cuddigan, 2007). This implies that the prevalence of pressure ulcers patients in the various health care institutions and organizations has been increasing yearly. Precisely, several studies have shown that general hospitals hold approximately 20% of patients with pressure ulcers, 10% in higher learning healthcare institution and 31% in the special home care organizations. As revealed, there is relation between the incident rates and the health care settings, whereby higher occurrences are expected within institutions lacking skilled labor forced and those lacking adequate modern facilities. In this case, home based health care organizations record the high incident occurrence rates, as compared to public hospitals and those designated health departments of the higher learning institutions. However, in-depth studies have indicated that the problem varies greatly with the different types of pressure ulcers. The superficial pressure ulcers which are generally known as stage I ulcers are much higher in prevalence, but their prevalence is decreased due to their easy detection, hence, the deep type of ulcers which most affects mostly the muscle and develops faster becomes the commonest due their uneasy detections and healing (Cuddigan, 2007). This brings the sense that pressure ulcers are a major problem affecting thousands of people from all areas indiscriminate of their profession, age, genders and other demographic factor considerations.
Even though studies in the American health care institutions have depicted an increase of more than 60% of the pressure ulcers patients for the past decade, evidences show that there are no accompanying ramifications in the number of individuals being hospitalized. Nevertheless, it should be noted that the occurrence rate varies greatly depending the settings of the organization. The corresponding hospitalization of pressure ulcers patients for the past decade is approximated at 10%, a percentage which is very low in comparison to 60%. Despite of the low admission rates to the hospitals, the treatment costs remains to be a major problem in connection to pressure ulcers prevention and control measures. Many hospital records indicate that pressure ulcers treatment cost is much higher than the treatment of other common sophisticated type of health problems, and its cost charge mostly averages at $ 40, 000 per individual put under normal hospitalization. The annual accumulated cost is estimated to be almost half a billion dollars per state. This high costs and expenses is associated with several factors which include and are not limited to lengthy hospitalization of patients together use of expensive equipments and materials (Iglesias and Hawkins, 2006). This further shows how bedsores are a key problem in the ministry and institutions of healthcare provision.
In brief, the problem of pressure ulcers has been an issue of major concern in the health care sector, specifically within the field of nursing. Nurses showed the spirit and their concern of eradicating or eliminating pressure ulcers since mid of the 20th century, but it is not surprisingly that the occurrence rates has been on the increasing trend even up to date. Several reviews show that post pressure ulcers is an indication of the nurse’s fault and mistake, but not for the patient (Hampton and Collins 2005). That is to say, nurses ought to be blamed for the development of pressure ulcers as they depict and act as a mark of delivery of poor quality service by the nurse(s) to the recipients. Although this is a problem that can potentially be associated with the entire system of health care provision, the nursing department is much affected and its reputation tarnished due to its linkage with the poor service delivery patients together with reduced cooperation and collaborations with other department.
While the prevention and intervention measures for pressure ulcers become major of issue in the nursing field, the responsibility to check the problem is multidisciplinary one, with the nurses taking the core position in the control process. In the efforts of developing intervention and prevention measures, nurses have used different strategies to reduce the extent of pressure ulcers and post pressure ulcer development. Generally, the previous studied which nurses have employed comprises of predictive techniques based on friction, shear, moisture, nutrition, mobility and sensory activities. These are techniques which bear the features that closely link the problem of pressure ulcers to the factors of pressure intensity and duration. Though the past techniques have shown high sensitivity of 80% and above, the application of these methods is limited due their poor predictive or preventive values they give. Some of the system scales give results which shows large number of persons are at risk, while others would reveal contradictory results to the previous of not at risk. Overtly, the expected overall effects would be high costs and poor service delivery as numerous individuals whose results are poorly and oppositely reported ends up receiving unnecessary treatment (Hampton and Collins 2005).
Apart from using the tradition methods of preventing and measuring the effects of pressure ulcers, a more modern techniques have been used. The fragment strategy has been in use at the present times, however, the results are still not satisfying mainly because the method lacks adequate means to assess its preventive and intervention validity (Burns and Grove, 2009). To reduce the risk of developing a more advanced way capable to reduce or eradicate the problem, nurses are admonished to develop and improve their facilities to combat the menace of pressure ulcers. As the nursing and health department are still focusing on the preventive and intervention measures, it appears that participants in the nursing field should now focus on another area, especially that dealing with improvement of facilities. In this particular case, there is need to evaluate the changes which will be retrieved from the use of the various facilities including use different commercial mattresses, pillows and other overlays distributed by nurses. Thus, it is believed that many health care organizations will show great transformation through the use of supportive materials comprising of beddings and walk equipments improvement integrated with certain programs
References
Ayello, A., and Braden, B. (2005). Why is pressure ulcer risk so important? Nursing, 32 (11), 75-80.
Burns, N., & Grove, K. (2009). The practise of nursing research: Appraisal, synthesis, and generation of evidence. MO: Saunders Elsevier.
Cuddigan, J. (2007). Pressure ulcers in America: Prevalence, incidence, and implications for the future. VA: National Pressure Ulcer Advisory Panel.
Hampton, S., and Collins, F. (2005). Reducing pressure ulcer incidence in a long-term setting. BJN, 14 (15), 7-11.
Iglesias, D. and Hawkins, K. (2006). Pressure relieving support surfaces trial: Cost-effectiveness analysis. BMJ, 332 (755), 1416- 48.