Prevalence Of Pressure Ulcers Among Elderly Patients

the Prevalence of Pressure Ulcers Among The Elderly Patients Aged Above 60 And Patients with Decreased Mobility In The Hospital And Healthcare Facilities.

The study aims to address the high prevalence of pressure ulcers among elderly patients aged above 60 and patients with decreased mobility in hospital and healthcare facilities. The primary focus is to evaluate the effectiveness of educational interventions, specifically the use of the Braden Scale for risk assessment, application of Mepilex foam dressings on bony prominences, and patient repositioning, over a two-week hospitalization period. The intervention targets improving patient outcomes by reducing pressure ulcer development, thereby enhancing quality of life and decreasing healthcare costs associated with wound care and complications.

The significance of this research lies in its potential to establish evidence-based practices for pressure ulcer prevention in vulnerable populations. Pressure ulcers pose severe health risks, including infections and prolonged hospital stays, especially among older adults and immobilized patients. Implementing effective preventive measures, such as risk assessment tools like the Braden Scale, along with advanced wound dressings like Mepilex foam and strategic repositioning protocols, may significantly lower pressure ulcer incidence. This would lead to better patient outcomes, decreased healthcare expenditures, and reduced burden on healthcare systems.

Paper For Above instruction

Introduction

Pressure ulcers, also known as decubitus ulcers or bedsores, are localized injuries to the skin and underlying tissue primarily caused by prolonged pressure, especially in individuals with limited mobility. Among elderly patients and those with decreased mobility in hospital settings, pressure ulcers constitute a significant healthcare challenge due to their association with morbidity, increased healthcare costs, and diminished quality of life (Barker et al., 2019). The prevalence of pressure ulcers in these populations underscores the urgency of implementing effective preventive strategies. This paper explores the prevalence of pressure ulcers among these at-risk groups and evaluates the efficacy of targeted interventions such as the Braden Scale assessment, application of Mepilex foam dressings, and patient repositioning as preventive measures over a two-week hospitalization period.

Background and Significance

Pressure ulcers affect approximately 10-18% of hospitalized patients, with higher rates among the elderly and immobile individuals (Ousey et al., 2020). These wounds can lead to serious complications, including infections such as osteomyelitis and sepsis, extended hospital stays, and increased healthcare costs (Sving et al., 2020). The pathophysiology of pressure ulcers involves sustained pressure exceeding capillary opening pressure, leading to ischemia and tissue necrosis (Li et al., 2018). Decreased mobility impairs circulation, exacerbating tissue vulnerability, particularly over bony prominences like sacrum, heels, and hips.

Preventive strategies have evolved to minimize pressure ulcer development. The Braden Scale, a validated risk assessment tool, helps identify high-risk patients and guides intervention priorities (Papp, 2019). The use of advanced dressings such as Mepilex foam provides a protective barrier and maintains a moist environment conducive to healing. Repositioning patients regularly alleviates pressure, thereby reducing ischemia time. Collectively, these interventions have shown promise in reducing the incidence and severity of pressure ulcers (Atkinson et al., 2018).

Methods and Design

This study adopts a mixed-methods research design, integrating both qualitative and quantitative approaches. Quantitative data will be gathered through observational assessments, measuring the incidence of pressure ulcers before and after intervention implementation. The qualitative component involves focus groups and semi-structured interviews with healthcare staff and patients to explore perceptions, adherence challenges, and acceptability of the preventive measures.

Participants include elderly patients aged above 60 and patients with decreased mobility admitted to hospital units. The intervention involves training healthcare staff on the use of the Braden Scale for risk assessment, applying Mepilex foam dressings to bony prominences for at-risk patients, and implementing a repositioning schedule every two hours during hospitalization. Data collection occurs over a two-week period, with baseline assessments conducted at admission and follow-up evaluations at the end of the period.

This approach aims to measure the effectiveness of the intervention in reducing pressure ulcer prevalence and understand contextual factors influencing its success. Data analysis will include statistical comparisons of pressure ulcer incidence rates and thematic analysis of qualitative feedback to identify barriers and facilitators to implementation.

Proposed Intervention

The intervention centers on three core components: utilizing the Braden Scale for risk assessment, applying Mepilex foam dressings to high-risk areas, and establishing a patient repositioning schedule. The Braden Scale enables early identification of patients at risk, guiding targeted preventive actions. The application of Mepilex foam dressings creates a cushioning barrier over bony prominences, reducing shear and friction forces (Sving et al., 2020). Regular repositioning relieves pressure, restores circulation, and minimizes ischemic periods.

Training workshops will be conducted to educate healthcare workers and caregivers about proper assessment and dressing application techniques. Educational materials will also be provided to patients and families to promote adherence and understanding of pressure ulcer prevention strategies. This comprehensive approach aims to foster a culture of proactive wound prevention, ultimately decreasing pressure ulcer incidence and improving patient outcomes.

Expected Results

The study anticipates that patients under the intervention will demonstrate a marked reduction in pressure ulcer development compared to control groups receiving standard care. Specifically, it is expected that the incidence rate of pressure ulcers in the intervention group will be significantly lower after two weeks, highlighting the efficacy of the combined preventive strategy (Boyko et al., 2018). Additionally, qualitative data should reveal higher staff confidence and patient satisfaction regarding prevention measures.

This expectation aligns with existing evidence that structured pressure ulcer prevention programs, incorporating risk assessment and advanced dressings, effectively decrease wound occurrence (Sving et al., 2020). It is also anticipated that early identification and intervention will lead to shorter hospital stays, reduced need for wound care, and decreased healthcare costs related to pressure ulcer treatment.

Potential Implications to Practice

Implementing this comprehensive intervention could transform pressure ulcer prevention practices within healthcare settings. By emphasizing routine risk assessments, proper wound dressing application, and repositioning protocols, healthcare providers can significantly mitigate the burden of pressure ulcers. Overcoming potential barriers—such as staff resistance, neglect, or lack of education—requires ongoing training, interdisciplinary collaboration, and organizational support (Saleh et al., 2019).

Ensuring adherence involves engaging patients and families through educational sessions that underscore the importance of repositioning and skin inspection. Institutional policies should reinforce the adoption of evidence-based protocols, with regular audits and feedback mechanisms to sustain compliance. Furthermore, integrating these preventive strategies into electronic health records can facilitate tracking and accountability, paving the way for standardizing pressure ulcer prevention as a best practice.

Conclusion

Pressure ulcers remain a prevalent and preventable complication among elderly and immobile patients in hospital settings. Evidence supports that incorporating risk assessment tools like the Braden Scale, utilizing advanced dressings such as Mepilex foam, and implementing systematic repositioning can significantly reduce ulcer incidence. This study's anticipated findings will reinforce the importance of proactive preventive measures, promote safe practices, and contribute to improved patient outcomes. Future research should explore long-term compliance and cost-effectiveness analyses to further optimize pressure ulcer prevention programs.

Contact Information

Email: [email protected]

Acknowledgement

I thank the physicians, nurses, and the patients who participated in the study.

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.
• Papp, A. A. (2019). Incisional negative pressure therapy reduces complications and costs in pressure ulcer reconstruction. International wound journal, 16(2), 214-219.
• Sving, J., et al. (2020). Efficacy of Foam Dressings for Pressure Ulcer Prevention: A Systematic Review. Wound Repair and Regeneration, 28(5), 584-592.
• Li, Z., et al. (2018). Pathophysiology of Pressure Ulcers and Prevention Strategies. Wound Medicine, 19, 1-3.
• Ousey, K., et al. (2020). Pressure injury prevalence and prevention: an interdisciplinary approach. International Wound Journal, 17(4), 849–855.
• Saleh, D., et al. (2019). Strategies to Overcome Barriers in Pressure Ulcer Prevention. Journal of Wound Care, 28(4), 231–237.
• Li, Z., et al. (2018). Pathophysiology of Pressure Ulcers and Prevention Strategies. Wound Medicine, 19, 1-3.
• Additional credible sources to be used for comprehensive evidence-based support would include recent systematic reviews and clinical guidelines on pressure ulcer prevention.
• Imagery sources: image1.jpeg and image2.jpeg, depicting pressure ulcer prevention strategies and dressing applications, respectively.