Preventing Pressure Injuries in Healthcare: A Clinical Problem Analysis

Contents
Introduction......................................................................................................................................1
Potential clinical problem................................................................................................................1
Clinical Question.............................................................................................................................3
Conclusion.......................................................................................................................................4
References........................................................................................................................................5

Introduction
Preventing the pressure injuries in healthcare sectors, has been always a major challenge, on
both caregivers and patients. As a whole, due to epidemiology of pressure injuries which is
varied by clinical setting including potentially preventable condition. Nurses should use
Evidence based practice while taking care of patient. Evidence based practice means delivery of
health care that can be justify with the best evidence from patient care data and studies with
clinical expertise and patient preference and values in terms of their individual needs for well-
being ( Ellen Fineout-Overholt et. al., 2011). The risk of development related to pressure ulcers
or injuries might interfere with functional recovery of patient and can be complicated by pain or
any kind infection, which result in longer stays in hospitals. The present report is made to
describe potential clinical problem associated with “Pressure Injuries”, with formation of PICOT
question on same, to analyse its description.
Potential clinical problem
Patients in hospitals or homebound in long-term care facilities like nursing homes are facing
issues regarding mobility, due to health condition or age. To provide them care, health care
professionals generally avoid to encourage to move by own manner, in order to reduce risks
related with fallen during movement. But it increases risk of pressure injuries which is
considered as one of the biggest challenge for nurses or other medical practitioners. For the first
step of the evidence based practice nurses may have asked question to lay the ground work for
evidence based practice for example in case of injured patients who are not able to move and lie
on bed for longer period, are on higher risk of causing ulcers, back pain and more, due to
increase pressure on body (Melnyk et. al., 2010). This would also put a great impact on lives of
bed-ridden patients in terms of pressure ulcers on their body, as well as on ability of nurses for
rendering appropriate care to them. Evidence of presence of the pressure ulcers on patients, who
lie on bed for longer period, indicates the poor overall prognosis. This may contribute for
premature mortality within some patients. Considering some evidence based reports, it has been
analysed that pressure injuries are mostly seen in elderly populations; those who have less level
of nutrition or long-time ill (Thomas &Gregory, 2014).
A pressure injury is generally, localized skin damage or might be underlying soft tissue. This
kind of injury can be developed as intact skin, might be as an open ulcer and sometime results in
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painful condition (Anon, 2017). Prolonged pressure injury that often result in tolerance of soft
tissue for shear and pressure, are also affected by level of nutrition in body, perfusion,
immobility, co-morbidities, chronic wounds and soft tissue condition (Bhattacharya & Mishra,
2015).
However, a number of interventions have been taken to reduce such risks that arise due to
pressure injuries. It includes pressure-relieving devices, Hyperbaric oxygen therapy,
Electromagnetic therapy, risk assessments, Standard mattress, negative pressure wound therapy,
air beds and more to provide relief from actual injury arise due to prolonged pressure injuries
(Thomas, & Compton, Gregory 2014). All such therapies and medications processes are quite
effective in reducing impact of prolonged pressure or other kinds of factors that increases risks of
pressure injuries. It helps nurses and other associated practitioners to provide good care to
patients and support them, in prevention of occurrence of such issues. But it increases cost of
treatment for hospitals and also it refers to go beyond the affordability of those patients who
belong from lower middle class or poor background (Bhattacharya &Mishra., 2015). Therefore,
major group of people, who belongs from such population are on higher risk arise from
prolonged pressure injuries. Along with this, it also increases stress and put challenges on nurses
and medical team to provide proper care to such patients, without using high-cost treatment
procedures, which directly impact on desired health outcomes negatively. Therefore, to improve
healthcare practices and quality of patient outcomes, especially in case of prolonged pressure
injuries, it is essential to integrate EBP (Evidence based practices) in clinical practices. This
would help in making correct decisions for nurses about care treatment to support people to
prevent themselves from bedridden ulcers or other problems of pressure injuries.
Clinical Question
To provide better nursing care to the patient and to get maximum outcomes it is important to
determine real clinical issue and it must be in an answerable question. PICOT format is the most
used format in nursing care. And if question is asked in PICOT format then the search for the
evidence in clinical practice is significantly streamlined (Melnyk et. al., 2010). PICOT format is
systematic approach to get best evidence based available answer from the healthcare database
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