Because pressure ulcers are common among the inpatients, Memorial Hospital employed a number of strategies to reduce this condition at least by 50 percent, which has resulted in improved patient care and reduced cost of treating patients. The following discussion will discuss a plan that has been developed by a team of experts at Memorial hospital with an aim of reducing pressure ulcers. The research team concluded that all inpatients with a lengthy stay for more than 3 days on bed must be included in this project. The objective of the project is to reduce pressure ulcers especially at stage 2 and 4 among the patients. The findings have been highlighted in three phases namely; measure phase, improve phase, and control phase (Bryan-Brown, 2006)
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Measure phase is the initial stage that the team focused on to assess the current system in place including inputs and out puts (Burns and Grove, 2009). As such, the team observed that there are many changes that must be improved in the hospital to improve patient care. First, Braden Scale was performed to ensure that there is consistence of the result obtained by staff RNs and those obtained by enterostomal therapy RN (Burns and Grove, 2009). The findings proved that there was no consistency and therefore there is need to standardize the procedure. Generally, the team recommended that there is need to increase frequency of Braden Scale, there is need to use heel protectors, use correct procedures to prevent moisture on the patient’s skin, use of a special mattress called ripple mattress to reduce friction, and rotating the patient at least every 2 hours to prevent development of bedsores (Burns and Grove, 2009).
Improve phase recommends for improvement of all factors that increases risk of developing pressure ulcers (McCaffery and Pasero, 1999)). The recommendation says that to reduce cases of bedsores, Braden scale must be used regularly, educate nurses on how to interpret Braden Scale competently, implement new prevention and treatment procedures, and develop policies to curb cases of non-compliance to the prevention and treatment procedures (Burns and Grove, 2009).
At the control phase, an official control plan was put in place to ensure that the changes will be long term and follow-up strategies are put in place to ensure continuous assessment of patients (McCaffery and Pasero, 1999)). As a reduction strategy, the numbers of tests performed on a patient using the Braden test must be increased to five days (Burns and Grove, 2009). Additionally, all nurses should provide a report of the patient when changing shifts, the order of treatment has to be followed as well as being revisited from time to time. This will ensure that treatment and care of the ulcers is organized.
Patients at the I.C.U are at a higher risk of developing pressure ulcers because they spend most of the time in bed, have reduced pain sensitivity, lack of movement and poor nutrition among others (Marieb, 2004). To reduce pressure ulcers among these patients, all nurses must attend seminars for special training on how frequent to turn the patient to avoid developing ulcers. Secondly, pressure-relieving devices should be used on patients at risk of developing pressure ulcers (Marieb, 2004). Alternatively, a test to determine if a patient is developing pressure ulcers should be conducted on regular basis. Finally, the general care to a patient has to be improved.
In all hospitals, nurses should be trained on good nursing techniques and ways of dealing with pressure sores (Burns and Grove, 2009). The trained team should be very attentive to risky patients to ensure effective management of pressure ulcers at early stages of development, which is grade 1 because ulcers are easy to manage at stage 1 compared to stage 4 that is very severe, destructive, and has higher infection risks (Burns and Grove, 2009).
Bryan-Brown, C. (2006). Evidence-Based Practice is Wonderful. American Journal of Critical Care 83(1),pp.34-45.
Burns, N., & Grove, S. (2009). The practice of nursing research: Appraisal, synthesis, and generation of evidence. (6thed.) St. Louis, MO: Saunders Elsevier.
Marieb, E. (2004). Essentials of Human Anatomy and Physiology. San Francisco, CA: Pearson Benjamin Cummings.
McCaffery, M. & Pasero, C. (1999). Pain: Clinical Manual. Maryland: Mosby Inc.