Practice-Related Problems – Pressure Ulcers

Pressure ulcers are injuries that occur on the skin or in underlying tissues and their main cause is pressure combined with shear or excess friction. Pressure ulcers are in other words called decubitus ulcers or simply bedsores. The main purpose of this assignment is to explore in deep about pressure ulcers, how its address can enhance practice skills and how its control contributes to the public good.

Practice Setting Problem

A pressure ulcer is a highly prevalent problem in USA, Asian, Middle East, Latin America and African countries. It mainly affects sensitive body organs such as the hips, knees, elbows, ankles, cranium, sacrum, coccyx among others. This ulcer occurs due to the excess pressure exerted on the soft tissues in the human body that makes the blood flow to be obstructed. The disease is also by shear since it can excessively pull on the blood vessels whose main function is to supply the skin with blood. However, this condition does not affect the persons who are actively moving from one place to the other. The most common victims to this ulcer are people who are confined to beds, wheelchairs or those who strain their muscles while sited. In addition to confinement to wheelchairs, beds and chairs, there are other medical and nutrition factors that can make the skin not be able to withstand high pressure and shear. Some of these other risk factors include diseases that reduce blood flow, malnutrition, skin wetness caused by sweating or diseases that reduce skin sensation (Schimidit & Brown, 2012). Treatment of pressure ulcers may be obstructed or hindered by personal and physiological problems such as age of the patient, medical complications such as diabetes, use of some medical drugs as well as smoking.

Practice Significance to the Clinical Problem of Nursing

Pressure ulcers are of high significance to the nursing practice given that it is one of the most common community issues that affect the people on a daily basis. To begin with, this condition is effective in equipping the nurses with information on stages of disease development. Having the information on stages of disease development would then assist nurses to device proper preventive and control measures at the community level (Royal College of Nursing, 1998). For this case, a Pressure ulcer evolves and develops in six distinct stages and each stage is an amplification of the previous one. There is the first stage without any signs and symptoms, the second stage with little thickness loss of the dermis, the third stage characterized with full tissue loss, and finally, the fourth stage where all the tissues are lost and the bones, tendons and muscles are exposed. The last two steps are conditions of full blown, and there are deep tissue injuries and urgent medical attention is essential at this point. Any practicing nurse may not be able to fully address the problem if he or she does not totally understand the stages of the disease development (Schimidit & Brown, 2012). The protective and control measures of this type of ulcers depend on the sickness stage in which the patient is in. This disease is also effective in equipping the nurses with an open mind that helps them to understand how physiological, medical and environmental factors interact in causing diseases in humans. The condition on the ground is caused by a wide range of factors such as exposure to pressure, shearing and climatic conditions. The disease equips nurses with knowledge in understanding risk factors and how proper interventions can be put in place so as to control diseases.

For BSN- prepared nurses, the main implication is exposure. The term exposure implies that a pressure ulcer is a disease of public concern whose effects are widely felt (Joanna Briggs Institute for Evidence Based Nursing and Midwifery, 2005). It is also a disease caused by multiple factors that interact across various levels. It is a disease that requires understanding of disease life cycle so as to plan preventive, control and treatment measure. This exposure is, therefore, very necessary not only in management of pressure ulcers but also other related diseases caused by environmental and lifestyle risk factors.

Impact on Patients and/or Community

A pressure ulcer is a deadly disease whose implication on the society should not be ignored. The main impact of this disease to the society is death. Globally, it is estimated that about 43,000 deaths arise as a result of this disease annually (Joanna Briggs Institute for Evidence Based Nursing and Midwifery, 2005). For the USA, 2.5 million people develop pressure ulcers each year which varies across regions and levels of disease. 10 % to 18 % have acute conditions while 28% have long term one. Some individuals find themselves in intensive care units, in situations where infections are compromised. The disease is also prevalent in other global regions especially in Latin America and Asia (Joanna Briggs Institute for Evidence Based Nursing and Midwifery, 2005).

A pressure ulcer is mainly prevalent among the elderly and middle aged people who are less mobile or those confined on wheelchairs. There are other severe complications that are caused by pressure ulcers. To begin with, pressure ulcers can result to other ailments. It results in a lot of sufferings to the patients and it is very costly to treat. Some complications that are associated with pressure ulcers are bladder distension, sepsis, amyloidosis, urethral fistula, anemia, among others. The patients are exposed to a lot of the suffering in the course of the life cycle of the disease. Some are not able to walk properly, some cannot sit down and carrying out other biological functions becomes impossible (Royal College of Nursing, 1998). The sores keep on recurring as many patients do not use the recommended treatment. The condition becomes worse especially for people with paralysis. In some conditions, pressure ulcers may result to renal failure that can consequently result to death. Finally, the victims of pressure ulcers have to bear with persistent pains until the time the condition is fully treated (Cleary & Leufer, 2008).

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