Introduction
Pressure ulcers are becoming a significant concern within healthcare settings. The issue affects mainly individuals with limited mobility and immobility. According to Etafa et al (2018), pressure ulcers have a profound impact on patients’ physical and mental well-being. However, the purpose of this paper is to explore the evidence surrounding pressure ulcers and identify their causes and contributing factors. Achieving this required the researcher to rely on peer-reviewed articles and electronic databases.
Problem
The problem for consideration revolves around the increasing concern about pressure ulcers in hospitals. According to Etafa et al. (2018), pressure ulcers are characterized by restricted injury to the skin and underlying tissue. They are common in individuals who are immobile or have limited mobility. In the U.S. alone, approximately 1 million individuals develop pressure ulcers each year (Ebi et al., 2019). Pressure ulcers, if left untreated, can have a profound impact on an individual’s physical, mental, and social well-being.
By addressing the issue, this paper aims to improve patient outcomes and overall healthcare quality. Guided by research questions on current concerns related to pressure ulcers, healthcare providers can develop targeted measures to address them. The researcher’s focus is to inform care providers of the need to implement preventive measures to reduce the occurrence of pressure ulcers. Healthcare providers should also adopt measures to minimize the number of patients who develop pressure ulcers while under care. In essence, addressing these research questions can lead to a better understanding of the problem.
Moreover, by addressing the research questions, the researcher hopes to contribute valuable knowledge to the field. Pressure ulcers are considered preventable based on Ebi et al.’s (2019) findings. Therefore, the researcher hopes to raise awareness among healthcare providers and policymakers. They need to understand the importance of preventing pressure ulcers and their impact on patients. Overall, the research aims to reduce the prevalence of pressure ulcers and enhance the quality of care provided in healthcare settings.
Search Strategies
From the onset, the researcher identified keywords based on the research questions and problem of interest. Guided by this, the search strategies revolved around accessing peer-reviewed articles from reputable journals. Firstly, the researcher sought advice from a local librarian who recommended sources. One such source was the BMC Nursing Journal, which contained valuable information on the research topic, as seen in Etafa et al. (2018). The researcher focused on peer-reviewed articles with a sufficient sample size to ensure the credibility of the information.
Another strategy utilized in this research was visiting different electronic databases. A good example here was Scopus and Web of Science. An example of a source from the Web of Science is McLeod (2023). These databases are renowned for their comprehensive coverage of the scientific literature. Scopus, owned by Elsevier Publishing House, offers a vast array of publications from various fields, making it a valuable resource.
Level of Evidence
For clarity, the levels of evidence can be categorized based on the type of research conducted. The hierarchy of evidence is often classified into different levels (up to Level VII). The classification process is based on the methodological quality of their design. Randomized controlled trials (RCTs) and systematic reviews are of higher quality. Observational studies and expert opinions are considered to be of lower quality.
The search strategies adopted by the researcher yielded several sources related to the research topic. The sources range from Level II evidence (cross-sectional studies) to Level III evidence (process evaluation with mixed methods). There was also a source from Level IV evidence (qualitative descriptive study), with one Level V evidence source (continuing medical education article). Each level of evidence identified has its strengths and limitations. Therefore, the researcher must evaluate the quality of evidence when concluding.
Moreover, from all the sources identified through the search strategies, two were of Level II evidence. These sources are Ebi et al. (2019) and Etata et al. (2018). Roberts et al. (2017) is classified as Level III evidence because the study is a process evaluation of a cluster-randomized trial. Additionally, Roberts et al (2016) is considered Level IV evidence because it employs a qualitative descriptive approach. Finally, Mervis and Phillips (2019), which integrated a continued medical education approach, is Level V evidence.
Literature Review
A lack of awareness and knowledge about pressure ulcers is a significant healthcare concern. Based on Ebi et al.’s (2019) findings, 91.5% of nurses had inadequate knowledge of pressure ulcer prevention. This lack of awareness can contribute to the occurrence of pressure ulcers in patients. Similarly, Etafa et al. (2018) explored nurses’ attitudes toward pressure ulcer prevention, with findings revealing that the majority of nurses had a negative attitude. Such attitudes lead to a higher incidence of pressure ulcers among patients.
Current concerns regarding pressure ulcers are often viewed as an indicator of poor quality of care. Roberts et al.’s (2017) study emphasizes the importance of patient participation in care. Although the care bundle was highly effective, the main trial showed a 42% reduction in pressure ulcer risk. Statistically, the 42 percent reduction is below the required level. Overall, the findings shed light on the ongoing challenge of effectively preventing pressure ulcers in healthcare settings.
Moreover, addressing the high incidence of pressure ulcers requires the implementation of preventive measures. Nurses’ attitudes, awareness, and knowledge play an important role in the implementation process. In most cases, barriers such as heavy workload, inadequate staff, and shortage of resources hinder the implementation of preventive measures (Etafa et al., 2018). Similarly, patients’ perceptions of pressure ulcers, as observed by Roberts et al. (2016), are crucial concerning the acceptability of these measures. Based on these findings, there is a need to train healthcare professionals and engage patients in preventive care.
In line with the above, healthcare providers encounter numerous challenges when implementing preventive measures for pressure ulcers. Lack of knowledge and training are among the most critical challenges. As evidenced in Etafa et al.’s (2018) study, this affects their ability to prevent pressure ulcers effectively. Furthermore, the shortage of pressure-relieving devices and staff also hinders prevention efforts (Ebi et al., 2019). As such, overcoming these challenges requires the adoption of an evidence-based approach focusing on education and resource availability.
Overall, several factors contribute to the high incidence of pressure ulcers. One such factor is immobility – pressure develops due to prolonged pressure on the skin and underlying tissues. Etafa et al. (2018) noted that pressure ulcers occur as a result of immobility. Another factor, as discussed by Ebi et al. (2019), is the lack of preventive measures. Therefore, understanding these factors is crucial in developing effective prevention strategies.
Solutions
The primary solution to the problem centers on education and training. Implementing comprehensive education and training programs on pressure ulcers will help improve patient outcomes. Ebi et al. (2019) results showed that most nurses had inadequate knowledge in this area. Training helps ensure care professionals learn about risk assessment and early detection. This should be an ongoing endeavor to ensure healthcare providers remain updated with the latest best practices.
Furthermore, healthcare providers require resources and enhanced support from stakeholders. According to Etafa et al. (2018), nurses commonly encounter obstacles like heavy workloads and staff shortages. However, these challenges can be overcome with sufficient resources. For example, hospitals should ensure they have adequate staffing levels. This measure, combined with the necessary resources, will enable nurses to provide high-quality care.
Conclusion
Pressure ulcers are a major issue within the healthcare setting. The issue affects a significant number of patients each year (Ebi et al., 2019). Pressure ulcers affect mainly individuals and patients who are immobile. Its impact on individuals goes beyond physical discomfort – it affects mental, social, and financial aspects. This highlights the urgent need to address the issue by implementing comprehensive education and training programs.
Moreover, the successful implementation of preventive measures relies on the availability of resources and support from stakeholders. This is necessary to overcome the challenges mentioned by Etafa et al. (2018). They include heavy workloads, staff shortages, and inadequate pressure-relieving devices. Addressing these challenges by providing sufficient resources can empower staff to deliver high-quality care. Most importantly, collaboration between healthcare institutions and policymakers is crucial in addressing pressure ulcer prevention.
The literature review also highlighted the importance of addressing nurses’ negative attitudes toward the prevention of pressure ulcers. Nurses’ attitudes play an important role in addressing pressure ulcers. Similarly, preventive measures should consider patients’ perceptions to improve acceptability. The literature also emphasized the need to understand the contributing factors to pressure ulcer development. Overall, addressing pressure ulcers requires the adoption of a comprehensive approach that encompasses education, resource allocation, and patient engagement.
References
Ebi, W. E., Hirko, G. F., & Mijena, D. A. (2019). Nurses’ knowledge to pressure ulcer prevention in public hospitals in Wollega: A cross-sectional study design. BMC Nursing, 18(1), 329–339.
Etafa, W., Argaw, Z., Gemechu, E., & Melese, B. (2018). Nurses’ attitude and perceived barriers to pressure ulcer prevention. BMC Nursing, 17(1), 281–287.
Mcleod, S. (2023). Qualitative vs Quantitative Research Methods & Data Analysis. Simply Psychology.
Mervis, J. S., & Phillips, T. J. (2019). Pressure ulcers: Prevention and management. Journal of the American Academy of Dermatology, 81(4), 893–902.
Roberts, S., McInnes, E., Bucknall, T., Wallis, M., Banks, M., & Chaboyer, W. (2017). Process evaluation of a cluster-randomized trial testing a pressure ulcer prevention care bundle: A mixed-methods study. Implementation Science, 12(1), 148-153.
Roberts, S., McInnes, E., Wallis, M., Bucknall, T., Banks, M., & Chaboyer, W. (2016). Nurses’ perceptions of pressure ulcer prevention care bundle: A qualitative descriptive study. BMC Nursing, 15(1), 3416–3424.