Pressure Ulcers: Risk Assessment, Factors, and Prevention

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Pressure Ulcers
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Pressure Ulcers
Pressure ulcers develop in patients that sit in a single position for long the sores develop
is specific pressure areas for people who are confined in bed or wheelchairs for a long period of
time. These sores cause serious problems that can be life-threatening to patients if not treated
well. In most cases, people fall under this risk if they are bedridden or spend most of their time in
bed or in a chair (Serrae, Leen, Schols, Hecke, & Verhaeghe, 2017, p. 376). The development of
the sores varies from patient to patient, some patients may develop quickly while others may take
time to develop them. The common symptoms that patients show are swelling, pulse-like
draining and tender areas.
Risk assessment
Risk assessment in pressure ulcers entails determining the people that are at the risk of
developing the problem and at the same time developing preventive measures for addressing the
problem that the patients face. A pressure ulcer is one of the challenging risk factors that
organizations face since, despite the fact that different methods have been proposed on how to
prevent them, their prevalence still high, especially in older people (Moysidis, Niebel & Bartsch,
2011, p. 581). This means that the risk is a burden to all people who are bedridden or sit most of
the time on chairs. The risks that they present are high since they lead to the increased burden of
disease while at the same time present challenges for healthcare teams. Since people in this
category spend most of their time in one position, they are at a higher risk of developing the
condition.
Serrae, Leen, Schols, Hecke, & Verhaeghe (2017, p. 5 argue that pressure ulcer exists in
different stages that patients go through as the signs and symptoms of the disease manifest.
These four stages are normally caused by friction on the sin, shearing, pressure and sometimes

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force that is exerted due to the patient staying in one condition for a long time (Rich, Shardell. &
Hawkes, 2011, p. 1061). The unequal distribution of pressure when patients stay in one condition
for a long time is what causes the pressure ulcer to develop due to poor circulation and thus
increasing the pressure exerted on the surface causing the ulcers to develop. The outcome will be
the skin suffering from any small effects of friction, pressure and shearing forces to form ulcers.
In a study by Kirman (2018, p. 3) it was reported that pressure ulcers have been difficult
to assess since in most cases, the studies done in this field are qualitative and based on random
observation of uncontrolled studies. Which means that some questions have not been asked well
to document the risk of the problem. The cost of treatment has been shown under table one as
shown below to treat a single episode (Bennett, Dealey, & Posnett, 2014, p. 233). The average
cost of pressure ulcers to NHS varies from grade to grade ranging from grade1, 2, 3 and 4. The
cost per day is estimated at £38, £42, £50, and £50 per day respectively for normal healing. On
the other hand, the average cost per episode is £1,064, £ 3,948, £6,350 and £7,750 per episode
per day (NICE, p. 4). Further, Guest, Fuller, Vowden, & Vowden (2018, p. 5) add that pressure
ulcers have been estimated as likely to occur 4-10% of patients that have been admitted in
hospitals. Most studies have reported difficulties quantifying ulcers because they are complex in
nature due to the methods used to collect data on the topic that vary from study to study which
make it difficult to give an accurate figure of the people affected by the problem. Despite the
varying statistics, it has been indicated that at least 2000 patients are reported as having
developed new pressure ulcers each month in the UK (NICE 2019, p. 6). In addition to that,
older people are the ones who are more likely to develop the problem where almost a third of the
older people aged seventy and above have had hip surgery at one point in life. This means that
they have to be bedridden which in turn leads to pressure ulcers. This means that age alone is a

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risk factor since older people are associated with smoking, dry skin, urinary incontinence,
chronic systemic conditions and even hip fracture. People with spinal injuries are also another
special group where 20-30% of people with spinal injuries are likely to develop pressure ulcers.
In the UK this risk is associated more with the older population because there are many
older people who are bedridden or stay longer on wheelchairs. The population of the old keeps
on increasing thus causing an increased burden of the disease and increased NHS costs. Sulliva
& Schoelles (2013, p. 412) Add that despite the fact that many strategies and methods have been
developed to address the problem, there are still challenges that have been reported in patients
and healthcare setting for the people who are developing the pressure sores. This implies that the
risk is high and thus the need to address the issue by educating nurses on how to reduce the
effects of the problem and at the same time ensuring that there is access to enough resources for
use. To assess the risk of the pressure ulcers in the patient, the water low tool will be used to
determine the level of the risk that the patient is facing (Nursing Times, 2010, pp. 4). The role of
this tool is to assist in making professional judgment on the level of risk. The tool containing two
side, the front side is used for assessing and scoring the patient vital signs while the back side is
used for guiding the nurse on how to undergo the process. According to NICE (2019, pp. 7)
when assessing the patients using the water low tool, the terms “at risk” and “high risk” are used
to identify people who have the likelihood of developing pressure ulcers. In this case, adults that
are at risk of developing pressure ulcers are those that are considered to be at the risk of
developing pressure ulcers after assessment while those that are at high risk are the ones that
show multiple risk factors that are identified during assessment like limited mobility, nutritional
deficiency, inability to reposition themselves and significant cognitive impairment. Neonates,
infants, children and young people who are at risk are the ones that after assessment or clinical