The Society of Hospital Epidemiologists of America (2005) defines pressure ulcers as lesions that appear due to unrelieved pressure that damages the underlying tissues. The author states that they result from the compression of soft tissues on bony regions or external surfaces. Whittington and Briones (2004), articulate that more than 1.5 million cases of pressure ulcers are reported annually in America. As a result, governments and health care providers have in the recent past acknowledged the fact that addressing and managing this ailment is not only necessary, but also important. However, despite the increased awareness campaigns, interest, and medical advancements in medicine, surgery, and nursing care, pressure ulcers have been declared as being among the major cause of mortality and morbidity. This is especially so in situations whereby patients are hospitalized for long periods or are in need of long-term care.
A study conducted indicated that pressure ulcers have an incidence rate of between 2.7% to 26% and a prevalence range of 3.5% to 69% among hospitalized patients. In regard to patients in the critical care units, the results showed that they were at risk with a 33% incidence rate and a 41% prevalence rate. Elderly patients admitted in hospitals after surgery had the highest risk as evidenced by the 66% incidence rate. Similarly, another study conducted in order to determine the prevalence rate of pressure ulcers in patients with spinal cord injuries and related conditions indicated that such persons were at a greater risk of getting pressure ulcers with an incidence rate of 25% to 66% (Whittington & Briones, 2004).
Economically, a study seeking to evaluate the hospital billing codes associated with pressure ulcers indicated that from 1993 to 2005, the number of people admitted due to these lesions had increased by 80% (Society of Hospital Epidemiologists of America, 2005). Another study conducted in the United States indicated that pressure ulcers increased a financial burden of close to $1 billion in terms of expenditure and more than 2.2 million bed days in the Medicare program. The results also indicated that the treatment of a single ulcer costs $2000 to $40,000, and a reconstructive surgery to correct the damage caused by these ulcers amounted to an estimated $25, 000 per patient (Society of Hospital Epidemiologists of America, 2005). Despite the evidence provided by numerous evident-based researches, little has been done to counter and/or mitigate the prevalence and incidence of these life threatening ulcers.
Proposed solutions and rationale
Arguably, the best solution for these ulcers is prevention. There are various interventions that can be implemented to achieve this goal. According to Whittington and Briones (2004), skin care is a viable preventive measure as it enables practitioners to maintain and improve the tolerance level of the skin of patients that have been identified as being at risk of getting these lesions. In addition, mechanical loading is also a good measure. Mechanical loading includes preventive interventions such as hourly repositioning of hospitalized patients at risk of getting pressure ulcers and placement of pillows and wedges in bony prominence areas to avoid friction (Clark, Hiskett and Russell, 2005). These measures will reduce the probability o an individual getting these ulcers.
Similarly, Clark, Hiskett and Russell (2005) recommend that people who have been identified as being at risk of getting these ulcers should be provided with support surfaces such as foam, gel, water and air bags, which act as effective pressure-reduction devices. In addition, the authors contend that health care providers should invest in creating awareness regarding the cause, impacts and prevention of pressure ulcers within and outside the hospital setting. This can be done by initiating training and retraining programs regarding these ulcers, distributing pamphlets and booklets that contain adequate and comprehensive information on pressure ulcers. These interventions will go a long way in promoting awareness and imparting knowledge on pressure ulcers, thereby enabling people to prevent and identify them before they get serious.
References
Clark, M., Hiskett, G., & Russell L. (2005). Evidence-based practice and support surfaces: are we throwing the baby out with the bath water? Journal of Wound Care, 14(10): 455-8.
Society of Hospital Epidemiologists of America. (2005). Infection control and hospital epidemiology. Sydney: SLACK.
Whittington, K. T., & Briones R. (2004). National Prevalence and Incidence Study: 6-year sequential acute care data. Adv Skin Wound Care, 17(9):490-4.