Detailed Analysis of Pressure Ulcers: Nursing Risk Assessment Report

This report delves into the critical topic of pressure ulcers, also known as bedsores, focusing on the application of nursing risk assessment tools in clinical practice. The introduction defines pressure ulcers and highlights their common locations on the body. The main body explores the selection and importance of risk assessment tools, specifically mentioning the Waterlow Score Tool and the Braden Scale Tool, detailing their methodologies and significance in identifying patients at risk. The report emphasizes the importance of risk assessment in nursing practice for improving healthcare quality and safety. It identifies key risk factors, including age, body weight, skin type, immobility, malnutrition, and neurological defects, explaining their relevance in the development of pressure ulcers. Furthermore, the report discusses actionable strategies to address these risk factors, including the need for multi-agency involvement and the implementation of preventive measures. The conclusion summarizes the key findings and reinforces the importance of proactive risk management in preventing and treating pressure ulcers. The report highlights the need for thorough clinical assessment, personalized care plans, and continuous monitoring to minimize negative impacts on patients and healthcare organizations. The report concludes by emphasizing the need for education, training, and reporting protocols to ensure effective risk management.

Pressure Ulcers

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
Choose a nursing risk assessment tool........................................................................................1
Discuss why this risk assessment is important in practice..........................................................2
Identify the different risk factors included in the risk assessment tool and explain their
relevance.....................................................................................................................................3
Discuss what actions could be implemented to address the identified risk factors, including
any multi-agency involvement....................................................................................................4
CONCLUSION................................................................................................................................5
REFERENCES................................................................................................................................7

INTRODUCTION
Pressure ulcers refers to localized areas of tissue necrosis that tend to occur when soft
tissue is compressed between a bony prominence and an external surface for a prolonged period.
These lesions are also called bedsores, decubitus ulcers and pressure sores (Dreyfus and et. al.,
2018). However, this kind of pressure take place commonly over sacrum, greater trochanter,
ischial tuberocity, malleolus, heel, fibular head and scapula. In context of this essay, it will focus
on nursing risk assessment tool and importance of risk assessment in clinical practices. It will
also includes different risk factors are given below.
MAIN BODY
Choose a nursing risk assessment tool
Risk assessment and analysis is a procedure which aids in identifying and managing the
problem related to any domain to face the threats and estimate the possible consequences of
problem. Risk assessment in nursing involves identifying the related hazards and risk patients or
the staff might have in the workplace. Actions should be taken immediately once the hazard has
been looked out. It is a regulatory standard and a legal law to carry risk assessments in
workplace. The risk assessment is determined using certain equipments and techniques to
observe and diagnose. For assessment of risk, following things should be consider which are
given below. Initially, taking notes and footnotes on hazards around the environment. However,
checking who is at the risk majorly from the hazard. Meanwhile, evaluating the potential risk
from hazards and to check whether the safety measures are adequate. Moreover, concluding the
findings of report.
Pressure ulcers which are also known as bedsores or pressure sores are injuries or wounds
to the skin or beneath it. The pressure ulcers have been observed to majorly caused by elongated
pressure on the skin. It usually affect those individual who restricted to or sit on chair for much
longer period of time (Smit and et. al., 2016). Various Risk assessment tool is present for
pressure ulcers which identify the risk to an individual for developing ulcers and assist health
specialist and professionals to assess the risk. Main tools used for assessing the risk of pressure
ulcers are:
Waterlow Score Tool : Waterlow score or scale provides an assessed risk for the
development of pressure ulcers in a patient. This tool was originally developed by Judy
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Waterlow a clinical based nurse teacher in 1985. Areas like age, sex, body weight, height, skin
type, lifestyle, diet, malnutrition screening test, mobility, any surgery, previous trauma,
malnutrition or any neurological defects are assessed thoroughly for scoring the level of risk an
individual has for pressure ulcers. A potential and defined score range is 1 to 64. Waterlow score
above 10 signals risk of pressure ulcers. Score above 15 considers as a high risk Waterlow score.
An extreme high risk is score above 20. Such score reveals the potential risk to have pressure
ulcers. Once the score is determined preventive measures and interventions can be considered to
lower the chance of getting the disease (Fabbruzzo-Cota and et. al., 2016).
Braden Scale Tool : Braden scale is also a type of tool used to predict and check the risk
to an individual of getting pressure ulcers. This tool was originally given by Barbara Barden and
Nancy Bergstrom in 1987. Six criteria are examined to predict the risk level namely, moisture,
activity, mobility, nutrition, friction and shear. After examining the criteria score card is formed.
Higher the score is more chances are there to develop pressure ulcers.
Discuss why this risk assessment is important in practice
Risk assessment is the process of analysing hazards that may lead to a negative impact on
organisational business operations. Risk assessment is important in nursing practices to identify
risks and hazards that may cause harm to patients and staff members. Clinical risk assessment is
important for improving quality and safety of healthcare services. Risk assessment is important
for a work place because it helps in to develop strategies use to identify ways to reduce hazards.
Care practitioners should develop their own personal care and safety plans (Skytt and et. al.,
2016). Managing risk in a healthcare system involve healthcare practitioners to engage with the
patient to work with best practices and policies.
Conducting risk assessment and safety planning to patients will require care practitioners
to connect with patients and help them to establish willingness and ability in cases where there
are no certainties and guarantees. In healthcare system, there are chances of arising risks at any
moment during patient care. Practices of service providers such as diagnosis, prescribing
medicines, performing screenings, and giving vaccinations to parents include several number of
risks which are need to be assessed. As a healthcare practitioner it is important to convey
everything and provide necessary information on which there are chances of making decisions to
their patients regarding their treatment.
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However, risk assessment is very important in treating medical disorders like pressure
ulcers. Pressure ulcers which is also known as bed sores, is a sort of injury to skin and tissues
causes from continuous pressure on skin. It covers bony areas of body like feet, ankles,
heels,buttocks etc. Care practitioners of such diseases need a proper and systematic approach.
Clinical assessment should include the ulcer history and analyse the cause of their occurrence.
Practitioners should have a proper knowledge of which stage of pressure ulcer a patient is facing.
Thus, actions are need to be planned after analysing the symptoms of patient (Byrne and et. al.,
2016). A planned and personnel care plan should be implemented on patient to treat the disease.
It will help a care practitioner to analyse weather a controlled program is required for particular
risks arising during treatment.
Hence, risk in clinical practices and environment need urgent strategies to minimise the
negative impact on patient as well as on healthcare organisation. In order to tackle risks hazard, a
care practitioner should first identify the risk which is arising and then analyse how a patient can
be harmed through that risk. The next step is to assess the risk properly and identify its impact.
At last, a proper action or treatment is need to be done for managing risk. There should be a
proper documentation or record of the finding in risk assessment which include all necessary
details of the hazards and a review of risk assessment should done to analyse new clinical
practices, new technologies and strategies.
Identify the different risk factors included in the risk assessment tool and explain their relevance
Risk factor is any characteristic or attribute of an individual that enhances the chances of
developing any particular injury or disease. Risk factors are considered as a important part of
clinical practice and proves to have a central and main role in predicting and preventing any
disease or injury. Identifying risk factor can help in dividing the group of people into low risk
and high risk categories (Tallier and et. al., 2017). The individual having high risk score has
more probability of negative outcomes as compared to the low risk group. Some risk factors
which are included in risk assessment tools are explained here.
Firstly, Age is considered as a demographic factor which is used as a risk factor in
Waterlow score tool. Old people tend to sit more at one place as compared to youths and adults,
so they have more risk of getting pressure ulcers. Many health problems gets worse or develop
during old age apart from pressure ulcers. Secondary, Body weight consist individuals with high
body weight get pressure ulcers more easily than others. Excess body weight can cause many
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health related problems like high blood pressure, obesity, thyroid, cardio vascular diseases and
many more. So regular weight measurements and their remediation method should be followed.
Thirdly, Skin type involves the pressure ulcers majorly affect the surface of skin which is
noticed by reddening of area. If an individual has dark skin then the discoloured area is not
visible clearly. Thereby, the early signs are not noticed and remain untreated. However,
Immobility includes that lack of movement refers to an immobile state, such condition may be
due to spinal cord injuries or an accident (Creehan and et. al., 2016). This immobility increases
the risk of getting many diseases, out of which one is pressure ulcers. Clinical practices should
be considered whenever an individual faces this.
In addition to this, Malnutrition consist Diet in which all nutrients and minerals are not
enough to perform necessary function inside body leads to malnutrition. This cause is a very
common and major risk factor to cause number of diseases in children to adults. Moreover,
Neurological defects involves minor or major defects in neurons, mental disability can also be
regarded as a risk factors of many diseases including pressure ulcers. Such defects like in autism
a person sit at one position for a couple of hours without even realising. Such immobility due to
neurological or any previous trauma affects the individual mentally and physically.
Such risk factors if assessed at right time can lower the possibility of having the prior
disease and proper exercise, diet, lifestyle, habits and suitable medical precautions can easily be
taken to reduce the probability of having any disease.
Discuss what actions could be implemented to address the identified risk factors, including any
multi-agency involvement
Risk factors are chances of damage, injury, loss which is caused by susceptibility of an
individual or organisation. There can be many risk factors arising in a healthcare organisation
such as risks related poor health, diseases, disabilities or death. Society and service providers of
healthcare organisations are taking different actions in order to understand risk factors and
planning strategies to reduce them. Actions which are need to be implemented in managing risk
factors involve a proper clinical process, system or documents engaged to analyse, monitor and
assess to prevent risks. Actions which are need to be implement that are mentioned below.
Identifying risk: Healthcare practitioners are need to develop strategies for identifying
risks during a particular treatment. They should also develop response plans in case of immediate
actions. For treating diseases like pressure ulcers, healthcare practitioners should identify at-risk
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factors of patient and then implement specific preventive measures such as suggesting patient to
use pressure reducing surfaces, providing supplementation if needed etc.
Evaluating and prioritize risk: Once analysing risk, it is important to prioritize risk
based on their effects on treatment of patients as well as organisation. Based on the measures of
risk factors resources are allotted and tasks are assign to the employees to take actions. Risk
matrices and heat maps can be used to visualize risks and help in collaborative decision making.
Considering opinions of different stakeholders: Healthcare managers include
communication with stakeholders of organisation. In case of severe risks the managers and
supervisors of the healthcare organisation should consult with stakeholders of other organisations
also in order to develop appropriate strategies regarding risk management (Woo and et. al.,
2017). In case of a patient suffering from pressure ulcers, care practitioners should involve
opinion and views of other service providers also for the betterment of patient.
Purpose, goals and measurements: Developed plans should clarify the purpose and
benefits of implementing them in healthcare sector. Particular goals should be made in order to
minimize the overall cost of organisational risks.
Education and training: Risk management actions need training and development
sessions for the employees of organisation. It should include professionals who can teach clinical
practices. It will help organisation to tackle risks and hazards properly and they will be able to
deliver better care for heir patients.
Reporting protocols: Each and every organisation of healthcare system must use easy to
use and quick system for documenting, tracking and classifying risks. Documenting of the risk
assessment data should be done properly in a detailed form.
Thus, a healthcare organisation need a living document which must be updated regularly
and should be improved based on arsing risks, information and changes in organisation. Thus, by
implementing appropriate actions helps in to minimize risks and to treat diseases like pressure
ulcers in more effective manner.
CONCLUSION
From the above essay, it has been summarized that pressure ulcers can be described as a
situation when a soft tissue is compressed between a bony prominence and an external surface
for a prolonged period. It includes various risk assessment which are required to be determined
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in order to solve them for improving the relevant outcomes of clinical procedures in respect of
given health problem.
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REFERENCES
Books and journals
Dreyfus, J. and et. al., 2018. Assessment of risk factors associated with hospital-acquired
pressure injuries and impact on health care utilization and cost outcomes in US
hospitals. American Journal of Medical Quality, 33(4), pp.348-358.
Smit, I. and et. al., 2016. What factors are associated with the development of pressure ulcers in
a medical intensive care unit?. Dimensions of Critical Care Nursing, 35(1), pp.37-41.
Fabbruzzo-Cota, C. and et. al., 2016. A clinical nurse specialist–led interprofessional quality
improvement project to reduce hospital-acquired pressure ulcers. Clinical Nurse
Specialist, 30(2), pp.110-116.
Skytt, B. and et. al., 2016. A longitudinal qualitative study of health care personnel's perceptions
of simultaneous implementation of three risk assessment scales on falls, malnutrition
and pressure ulcers. Journal of clinical nursing, 25(13-14), pp.1912-1922.
Byrne, J. and et. al., 2016. Prophylactic sacral dressing for pressure ulcer prevention in high-risk
patients. American Journal of Critical Care, 25(3), pp.228-234.
Tallier, P.C. and et. al., 2017. Perioperative registered nurses knowledge, attitudes, behaviors,
and barriers regarding pressure ulcer prevention in perioperative patients. Applied
Nursing Research, 36, pp.106-110.
Creehan, S. and et. al., 2016. The VCU Pressure Ulcer Summit—Developing Centers of
Pressure Ulcer Prevention Excellence: A Framework for Sustainability. Journal of
Wound Ostomy & Continence Nursing, 43(2), pp.121-128.
Woo, K.Y. and et. al., 2017. Exploration of pressure ulcer and related skin problems across the
spectrum of health care settings in Ontario using administrative data. International
wound journal, 14(1), pp.24-30.
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