Capstone Project Presentation On Pressure Ulcers Among Elder
Capstone Project presentation on pressure ulcers among elderly and mobility patients
Prepare a comprehensive academic paper addressing the topic of pressure ulcer prevalence among elderly and decreased mobility patients in hospitals and healthcare facilities. The paper should include an introduction that explains the significance of the issue, the background and implications for healthcare. Discuss evidence-based interventions such as the use of the Braden Scale, Mepilex foam dressings, and patient repositioning, supported by credible literature. Incorporate theoretical frameworks like Jean Watson’s caring theory to emphasize the importance of holistic patient care. Describe research methods, including qualitative and quantitative approaches, and how they can be employed to assess the effectiveness of interventions. Present expected outcomes, potential challenges, and implications for nursing practice and healthcare policy. Use appropriate citations to support arguments and conclude with recommendations for improving pressure ulcer prevention strategies in clinical settings.
Paper For Above instruction
Pressure ulcers, also known as pressure injuries or bedsore, represent a significant challenge within hospital and healthcare settings, especially impacting elderly and patients with decreased mobility. Their prevalence not only causes considerable morbidity but also poses substantial financial burdens on healthcare systems. The prevalence of pressure ulcers among vulnerable populations underscores the urgent need for effective prevention strategies that incorporate evidence-based practices, holistic patient care, and systemic policy changes.
Introduction and Significance
Pressure ulcers are localized injuries to the skin and underlying tissue resulting from prolonged pressure, often over bony prominences such as sacrum, hips, and heels (Atkinson & Cullum, 2018). They are particularly common in geriatric populations due to age-related skin fragility, reduced mobility, comorbidities, and diminished blood circulation. According to Saleh et al. (2019), pressure ulcers constitute approximately 70% of significant health issues affecting hospitalized older adults, and their management incurs a healthcare expenditure exceeding $20 billion annually in the United States alone. Such statistics emphasize the importance of developing and implementing effective preventative measures within clinical settings.
Background and Clinical Implications
The pathophysiology of pressure ulcers involves sustained pressure exceeding capillary closing pressure, leading to ischemia, cell death, and chronic wounds (Norman et al., 2020). If untreated, these wounds can become infected, leading to severe complications like osteomyelitis, sepsis, and even mortality. The elderly are notably at higher risk because of skin thinning, decreased collagen synthesis, and coexisting conditions such as diabetes and vascular disease. Moreover, pressure ulcers significantly prolong hospitalization, impair quality of life, and impose emotional and economic stresses on patients and their families (Papp, 2019).
Evidence-Based Preventive Interventions
Prevention of pressure ulcers relies on a multi-faceted approach integrating risk assessment, skin protection, patient repositioning, and nutritional support. The Braden Scale is a widely used validated tool for assessing pressure ulcer risk, guiding preventive measures tailored to individual susceptibility (Boyko et al., 2018). Its implementation helps identify high-risk patients early, prompting targeted interventions such as repositioning and use of protective dressings.
An essential strategy in pressure ulcer prevention is the use of Mepilex foam dressings, particularly over bony points, to distribute pressure and minimize shear forces. These silicone-based dressings create a barrier that reduces friction, maintains moisture, and promotes wound healing if ulcers develop (Saleh et al., 2019). Regular repositioning, ideally every two hours, is another critical intervention to relieve pressure and improve circulation, thereby reducing tissue ischemia.
Theoretical Framework: Jean Watson’s Caring Theory
Jean Watson’s Theory of Human Caring emphasizes a holistic approach to nursing, focusing on caring relationships that promote patient well-being physically, emotionally, and spiritually. This middle-range theory advocates for attentive, compassionate care that addresses patients’ needs beyond just clinical procedures (Watson & Woodward, 2020). Applying Watson’s principles, nurses can foster trust and comfort, which are essential in implementing preventive strategies for pressure ulcers, such as skin inspection, repositioning, and educating patients and families about skin care.
Research Methods and Design
This project adopts a mixed-methods approach, combining qualitative and quantitative methodologies. Quantitative data may include pre- and post-intervention assessment scores using the Braden Scale, incidence rates of pressure ulcers, and wound healing metrics. Qualitative data can be gathered through focus groups and interviews with nurses, patients, and caregivers to explore perceptions, barriers, and facilitators of implementing preventive protocols.
For example, a cohort study could compare two groups of at-risk hospitalized patients—one receiving standard care and the other receiving the intervention bundle of Braden assessments, Mepilex dressings, and repositioning protocols. Qualitative interviews could capture insights into staff compliance, patient comfort, and organizational challenges, providing a comprehensive understanding of intervention effectiveness.
Expected Outcomes and Evaluation
It is anticipated that over a two-week period, the implementation of the combined interventions will significantly reduce the incidence and severity of pressure ulcers among the at-risk elderly and mobility-limited patients compared to control groups. Metrics such as the number of new ulcers, wound healing rates, and patient comfort levels will serve as primary outcome indicators (Boyko et al., 2018). The effectiveness of these interventions will be further validated through patient feedback and clinical assessments.
Challenges and Practical Implications
Nudging healthcare providers and families to adhere consistently to preventative protocols can be challenging due to resource constraints, staff resistance, or communication gaps. Addressing these issues requires comprehensive education programs targeted at staff and caregivers, emphasizing the importance of early risk assessment and proactive skin care (Saleh et al., 2019). Administrative support is critical to allocate resources and establish policies that embed pressure ulcer prevention as an organizational priority.
Strengths of this approach include the ability to empower patients and staff through education and active participation, fostering a culture of safety and continuous improvement. However, challenges such as limited staffing, financial limitations, and variable commitment pose barriers that must be managed strategically.
Conclusion and Recommendations
The evidence underscores that systematic application of the Braden Scale, the use of protective dressings like Mepilex, and routine repositioning are highly effective in reducing pressure ulcer prevalence among high-risk patient populations. Educational initiatives and institutional policies are vital in ensuring adherence to these preventive measures. Incorporating Jean Watson’s caring philosophy into practice reinforces the importance of compassionate, patient-centered care, ultimately leading to improved outcomes and reduced healthcare costs.
Future research should explore the long-term benefits of these interventions and examine ways to optimize resource allocation and staff training to sustain pressure ulcer prevention efforts effectively.
References
- Atkinson, R. A., & Cullum, N. A. (2018). Interventions for pressure ulcers: a summary of evidence for prevention and treatment. Spinal Cord, 56(3), 186.
- Boyko, T. V., Longaker, M. T., & Yang, G. P. (2018). Review of the current management of pressure ulcers. Advances in wound care, 7(2), 57-67.
- Norman, G., Goh, E. L., Dumville, J. C., Shi, C., Liu, Z., Chiverton, L., ... & Reid, A. (2020). Negative pressure wound therapy for surgical wounds healing by primary closure. Cochrane Database of Systematic Reviews, (6).
- Papp, P. (2019). Pressure ulcer prevention and management in elderly patients. Geriatric Nursing, 40, 558-565.
- Saleh, M. Y., Papanikolaou, P., Nassar, O. S., Shahin, A., & Anthony, D. (2019). Nurses' knowledge and practice of pressure ulcer prevention and treatment: an observational study. Journal of tissue viability, 28(4).
- Watson, J., & Woodward, T. (2020). Jean Watson's theory of human caring. SAGE Publications Limited.