Introduction
The main purpose of any health care institution is well known as being to provide the basic health care services to the seekers or recipients to restore/improve their health status, or even to maintain it. Depending on several factors that influence the quality and performance of the healthcare workers, there are certain circumstances which hinder easy delivery of the health care services or products, hence achieving the organization/institution’s goals appear as a big burden. Due to the development of unforeseen hindrances of services within healthcare organizations, poor outcomes are expected, which are marked by the failure of eradicating primary unhealthy condition, but the primary unhealthy conditions are escalated by the development of secondary conditions in patients, while they are still hospitalized undergoing treatment.
For that matter, many institutions/ organizations absorbed in the sector of healthcare and engaged in the provision of healthcare services directly to the recipients are having a major challenge on the arising of secondary conditions. Weight gain, urinary tract infection, bowel dysfunction, joint problem and pressure ulcers are a few of the illnesses and conditions identified to have higher chances of translating from primary condition to secondary condition. It thus becomes crucial to have a better understanding and a clarity of knowledge on health problems which have the potential of developing secondary condition, as this enables the formulation of techniques and sound control measures to mitigate or eradicate the problem (Burns & Grove, 2009). In this case, while working for XYZ hospital, a myriad of problems were evident in the organization, however, the problem of pressure ulcers was the worst of all, hence, I felt compelled to research and study more on it to reduce its severity in the future.
Background
According to the solid knowledge gained from the field of my profession and also that acquired from experiential activities, pressure ulcers is a condition brought about by the accumulation/ exertion of pressure resulting into destruction of some of the body organs or tissues. The most frequently affected area of the body comprises of the skin, body muscles and certain tissues that underlies within the body skin. Sometimes, it may also affect the blood tissue, especially under the condition of high pressure which is localized. This brings occlusion of the blood fluid flow, which in return leads to cell necrosis Though the condition is hard to classify, its classification is done depending on the extent of organ and tissues damages.
While working at the XYZ hospital, many patients were being brought in and got admitted in the theater and surgical department of the hospital for treatment. The hospital admitted all range of patients seeking and in need of wound and surgery services. That is to say, young people, adults, old adults, women and men among other categories were all accepted as eligible persons for the service. However, the hospital was initially set up to help women, the old ones and those on delivery period, a fact which made the organization to receive a higher number of female patients than any other cohort.
The population of surgical patients kept on increasing on the daily, monthly and even yearly basis. This increasing trend phenomenon of the number of patients was perhaps caused by an increase in the population, increasing number of accidents among other factors. Overtly, as the numbers of patients kept on increasing, this brought in an imbalance between resource requirements and patient’s quality service delivery. There were certain times when the number of patients exceeded the number of facilities available. During such a period of higher number of patients, than the carrying capacity of the department, patients would share some of the available resources such as beds and other facilities which should not be shared. In addition, the department acquired supplemental workers from other departments to aid in off-setting the situation. This meant that they lack the adequate skills and knowledge to serve and deliver standard quality services.
Generally, the lives of surgical patients at XZY hospital were improperly not taken care of. The patients’ welfare was compromised many a times, directly or indirectly due to the certain circumstances within the organization. For instance, as the number of patients in need of the institution’s health service exceeded the number of workers, some patients appeared to have been ignored. The patients would therefore bear with the workers’ situations, which were either busy serving others, or looked tired and exhausted to deliver their services. By so doing, some of admitted patients would lay down on the bed for a long period of time without turning their body. Others got tired of lying on same side sitting down on the bed would strain to turn on their own, or for those sitting would walk around without necessarily getting being supported, or even using the right supportive facilities that should be provided for safety purpose and enhancement of quick recovery. The conditions thus reflected at XYZ hospitals vividly shows that the organization was undergoing a crisis of problems (Burns & Grove, 2009). Thus, we believe that it is not wrong for someone to state ‘post surgical patients at XYZ Hospital are at a great risk of developing pressure ulcers.
Causal factors of pressure ulcers
The emergency of pressure ulcers is determined by several factors. Often, it is claimed that the development of pressure ulcers is depended upon the quantity of pressure exerted in relation to the kind of tissues or organs it falls on. Medical experts and professionals have identified and categorized causal factors of pressure ulcers as either intrinsic or extrinsic factors. On the side of intrinsic factors, these comprise of such factors like nutritional, degree of consciousness, immobility of activity and incontinence, while those belonging to extrinsic group are friction, moisture, shear and pressure. Like most of the other types of unhealthy conditions, pressure ulcers may be caused by one of these factors, or it may be a result of combined action of two or more factors acting concurrently or on an interplay manner.
Solution Description
In the effort of curbing and mitigating the health status of a person suffering from pressure ulcers, a myriad of approaches may be adopted. The approach procedure adopted is determined by the understanding of the nature of causal factor of the condition. In this connection, nurses have adopted preventive and intervention ways to treat and/or reduce pressure ulcer among patients. Their work is to ensure that the results prevent causing of injuries on the skin cover, reducing of skin injuries together with decreasing injuries to tissues underneath it. As revealed in the previous section of causal factors, a single or multiple factors may lead to the development of pressure ulcers, hence, requiring the employment of either single method or multidisciplinary approaches (Arthur, 2009). The following are some of the approaches which can be employed to solve the problem at XYZ hospital.
Improvement on load and support surfaces
One way of ensuring there is reduction of pressure ulcers is by the improvement of surfaces on which the patients lay on such as bedding among other things. The nature of surface on which a patient’s body comes into contact with determines the possibility of developing post pressure ulcers. Rough surfaces are likely to cause pressure ulcers than smooth ones. This does not affects the external surfaces of the skin, but it also greatly impacts the internal surfaces of organs. High pressure released from rough surface causes imbalance in the movement of the body organs, which generally increased the internal frictions of organ surfaces. The increasing pressure effect induces high chances of causing pressure ulcers by either damaging tissues or the entire organ. On the other hand, smooth and soft surface may reduce the chances of patients getting tired and exhausted within very short periods, and consequently this decreases the number of turns patients would make for given duration of time. In this case, there is reduced chance of increasing the frequency of friction, thus preventing the development of pressure ulcers related to frictional activity (Arthur, 2009).
The approach therefore requires the organization to improvise smooth and soft surface of the bedding section. In this connection, they will consider cushioning of bed edges and wedge surface parts. They would also have to check for a higher quality mattress and pillows, besides improvisation of the bed edges and wedge portion. Moreover, similar improvements are also required to be installed in facilities that are being utility by patients who can move around. This implies that, the management of the organization should make sure wheelchairs, various walking sticks and other walk equipments are well secured through cushioning to reduce frictions of the moving body parts that come into contact with the equipment. It should be noted that the edge and wedge treatment of the bed together with the walking equipment has several benefits, but it mainly helps in the proper distribution of body tissues, which results into reduction of heat and equal distribution of it (Bernade, 2007).
Other possible solutions
Apart from having improvised balanced load and surface parts of the equipment within the department, the XYZ may also reduce post pressure ulcers by applying several other methods. These are generally wound management techniques, and they include cleansing of the affected region with chemicals to prevent microbial and other pathological infections. Pressure ulcers debridement is also done on pressure ulcers showings signs and/or symptoms of pathological infection. Debridement reduces damaged tissues which provide favorable environment for pathological attack, hence, the removal of the necrotic tissues eliminate further chances of bacterial and microbial infection (Bernade, 2007). Another important way of curbing the problem of post surgical pressure ulcers is through the employment of topical dressing technique. A topical dressing technique is a very important method in alleviating the chances of developing post surgical pressure ulcers. It is a method which ensures entry of pathogens is prevented early in advance when the point having pressure ulcer is still fresh. The technique is very effective as it allows healing of the wound under the right conditions of moisture (Bernade, 2007).
Conclusion
Pressure ulcers are one of the disturbing and challenging conditions in the sector of health. However, the post surgical pressure ulcers appear to be the worst of all as it greatly affects not only the patients, but the entire system of healthcare provision. The post surgical pressure ulcers can be dealt with and be reduced in a number of ways. However, there is no single approach which has been identified as the most effective over the others. Furthermore, the use load and surface improvement strategy appeal to many professional in the XYZ Hospital as its employment has the potential likelihood of reducing treatment costs and increasing patient’s care satisfaction. Based on this study, I would highly recommend XYZ hospital to place its patients on a pressure relieving mattress during and post surgical procedure, since this will help reduce or eliminate friction/ shearing as well as minimize the patient’s skin exposure to high moisture and heat contents
References
Arthur, R. (2009). Outcomes measurements in nurse-midwifery practices. New York: Springer.
Bernade, S. (2007). Bridging the gap between pain and gender research. EJP 12 (5), 428-40
Burns, N., & Grove, K. (2009). The practise of nursing research: Appraisal, synthesis, and generation of evidence. MO: Saunders Elsevier.