Professional Issues and Policies Assignment 2022

Running head: PROFESSIOANAL ISSUES AND POLICIES
PROFESSIONAL ISSUES AND POLICIES
Name of the Student
Name of the University
Author notes

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Table of Contents
Introduction......................................................................................................................................2
Discussion........................................................................................................................................2
Description of the policy.............................................................................................................2
Impact of the policy on the Australian healthcare system...........................................................3
Complications of pressure ulcer..................................................................................................6
Conclusion.......................................................................................................................................7
References........................................................................................................................................8

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Introduction
The bed sores, also called pressure ulcer or the decubitus ulcers are harm or injuries
caused to the skin and the tissues underlying the skin. The pressure ulcers forms because of
prolonged pressure on the skin and the probable areas for the pressure ulcers are the skin which
covers the bony areas of the body like heels, hips, ankles and tailbone. Patients who are suffering
from diseases which restrict their abilities to change their positions on bed or those who spend
most of the time in bed have risks of developing bed sores or pressure ulcers (Jackson et al.,
2016). People suffering from bed sores have chances of developing serious complications, so in
order to prevent the formation of bed sores, it is better for the nurses to follow the preventive
measures so that the patients do not develop pressure ulcers (Li et al., 2016). This assignment is
going to deal with the bed sore care policy and the different preventive measures need to be
followed by the patients in order to prevent themselves from developing the pressure ulcers. The
policy of ‘pressure injury prevention and management guideline’ is one of the well-known
policies which provide guidelines to prevent the patients from developing pressure injury,
pressure ulcer, wound care and skin integrity (Nguyen, Chaboyer & Whitty, 2015).
Discussion
Description of the policy
The policy of ‘pressure injury prevention and management guideline’ was developed by
Public Health and Clinical systems and was approved by SA Health Safety & Quality Strategic
Governance Committee on 20 December, 2012. This policy was again reviewed on 31July, 2016.
This policy are applied to All SA Health Portfolio All Department for Health and Ageing
Divisions All Health Networks CALHN, SALHN, NALHN, CHSALHN, WCHN, SAAS Other.

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The policy helps the nurses to identify the patients who are at high risk, to know the preventive
strategies for the injuries. The policy also guides the nurses to classify the pressure injuries, pain
assessments, pain and wound management. The prevention of bed sore or pressure ulcer also
comes under this policy. The prevention of bed sore involves the different way by which the
development of pressure ulcers or the bed sores can be prevented. The bed sores effect to that
part of the skin which covers the bony areas like elbows, knees, coccyx, heels and ankles. The
pressure ulcers are curable but if the treatment starts at a late stage then it can lead to fatal
complications. Some special facts regarding the bed sores are that they only effect skin area
which covers the bony regions only and to those people only who cannot move. The
development of the bed sores occurs through different stages, so it is very important to identify
the stage of the bed otherwise the doctors and the nurses will provide wrong treatment methods
(Liang et al., 2017).
Impact of the policy on the Australian healthcare system.
This policy has guided the nurses in identifying the stage at which the bed sore is. Proper
treatment is required in order to reduce the complications of the disease. There pressure ulcer
develop in four stages, at the first stage the skin will appear red and the patient will feel warm
and itchy at the site of the infection. In the second stage, a painful sore or blister may appear and
area behind the sore gets discolored. In the next stage, the patient will develop a crater like
appearance because of the damage in the tissue. In the fourth stage, the skin and the tissue gets
severely damaged possibly because of infection and the muscles, bones and tendons of that
specified area may get visible.
People belonging from all age group, who spend most of the time in bed have chances of
developing bed sores however the chances of development of pressure ulcers are more to the

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aged people as they have to spend most of the time in bed. Most of the senior people suffer from
decline in the physical health as well as the decline in the cognitive abilities also are also
declined. The Australian healthcare system has improved a lot after following the guidelines of
the policy. The preventive measures which the Australian nurses are following are described
below:
 The nurses are educating the patient about the need of doing exercises. Ambulation and
ranges of motion exercises helps promoting circulation and the circulation helps prevents
the formation of pressure ulcer. Pressure sores often develop on the tailbone, hip regions,
shoulders or heels as the result of sitting in the wheelchair for a long period of time. The
nurses are allowing the patients to use wheelchairs only when necessary, otherwise the
aged people can use recliners or other more cushioned chairs. The patients who spend
most of the time on bed should be repositioned after specific period of time in order to
prevent pressure ulcer (Gharacheh et al., 2017).
 The nurse are regularly checking the skin of the patients for the signs and symptoms of
developing pressure ulcers. Sometimes, the pressure ulcers may develop within a few
hours for example soreness or redness appear in the buttock areas after sleeping for an
hour or more. The nurses regularly check the patient that whether there are any signs or
symptoms of pressure ulcers or not.
 It will be better for the patients if the nurses and the family members arrange special
bedding or materials to reduce the pressure. Depending on the needs of the patients,
special beds like water mattresses toppers or the air mattress toppers can be used. Apart
from these special cushioned padding like heel protectors may be needed to reduce the
pressure on the sensitive area of the body. The additional requirements must not be

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limited only to the mattresses or the modifications of footwear, instead the patient must
be provided with whatever the he feels comfortable with. For example, the pillow which
the patient uses must be provided after considering the needs of the patient. Some beds
can be used which provide the facilities of automatic turning, however they do not
provide the facility of completely repositioning a person (Wilson, 2015).
 The other method to prevent the formation of bed sores is keeping the skin dry and clean.
One of the biggest problem associated with the formation of bed sores is incontinence.
Degradation of skin occurs more rapidly when the bowel movement or the urine stays in
contact with the skin. The degradation of skin occurs because of the secretion of acid and
enzymes. If the patient do not change the position then pressure ulcer may develop in the
peritoneal area. If the area gets reddened then the patient any have developed stage I of
pressure ulcer and appropriate treatment must be provided. An appropriate barrier cream
can be provided in order to prevent from further excoriation.
 Maintaining a healthy diet is also essential to prevent the formation of pressure ulcers.
The circulatory system can function well till sufficient nutrients are delivered. In fact the
patients must be served with a well-balanced diet having the required nutrients in
sufficient quantities. The doctors or nurses are preparing the diet after considering the
diseases from which the patient are suffering, for example, the diet of the patient
suffering from diabetes will be different from the diet of the patient suffering from
mental diseases. So the other commodities must be considered before preparing the diet
of preventing the bed sores (Seong-Hi, P. A & Lee, 2016).
 The next policy of preventing the bed sores is managing of chronic health conditions in
an effective way. The chronic health conditions increase the risk of developing pressure

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ulcers. Any condition which affects the functions of the cardiovascular system results in
the poor blood circulation and thus the risk of developing pressure ulcer increases. The
nurses are monitoring the intake of fluid to those patients who are suffering from cardiac
issues, the nurses should restrict the diets of the aged persons who are have type II
diabetes or are suffering from kidney failures (Wettstein et al., 2015).
Complications of pressure ulcer
The pressure ulcer may get complicated if proper treatment are not provided to the patients
at proper time. Some life threatening complications are describe below;
 Cellulitis- This is an infection of skin and are connected with the soft tissues. The
infection cause redness and swelling of the affected area. However, people having
nerve damages do not feel the pain of the affected area (Akhtar et al., 2016).
 Infections of bones and joints- The infection from the pressure ulcers may cause
septic arthritis and osteomyelitis. The septic arthritis damage the cartilage and tissues
and the osteomyelitis affect the functions of joints and limbs (Kaur et al., 2016).
 Cancer- If the pressure ulcers are not treated for a long period of time then squamous
cell carcinoma develops (Järbrink et al., 2016).
 Sepsis- Rarely, a pressure ulcer led to the development of sepsis but if the infection
spreads throughout the body, then sepsis may happen.
If the conditions of the bed sores becomes severe, surgical interventions are necessary as
surgery cleans the sore, treat the infection and also prevent the patient from any further infection.
The surgery reduces the loss of fluid and also lower the risk of any further complication (Rai,
Varma & Wani, 2018). A part of the muscle, skin or any other tissue from the body of the patient
are used to cover the wound of the patient. So to protect the patient from the complications of

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pressure ulcer, the preventive measures have to be followed by the nurses and the family
members (Liu et al., 2015).
Conclusion
This assignment has dealt with the ‘pressure injury prevention and management
guideline’ sore policy and the different measures that the nurses should follow in order to
prevent patients from developing bed sores or pressure ulcers. The nurses must properly identify
the stage of the bed sore before starting of treatment and it is better to start treating the patients at
an early stage to avoid the development of complications of the disease. Till now the policy has
improved the Australian healthcare system to a great extent and hopefully in future also this
policy will improve the healthcare system of the country.

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References
Akhtar, N., Kamran, S., Singh, R., Cameron, P., Bourke, P., Khan, R., ... & Al-Yazeedi, W.
(2016). Prolonged stay of stroke patients in the emergency department may lead to an
increased risk of complications, poor recovery, and increased mortality. Journal of Stroke
and Cerebrovascular Diseases, 25(3), 672-678.
Gharacheh, L., Torabipour, A., Khiavi, F. F., Malehi, A. S., & Haddadzadeh, M. (2017).
Comparison of Statistical Models of Predict the Factors Affecting the Length of Stay
(LOS) in the Intensive Care Unit (ICU) of a Teaching Hospital. Materia socio-
medica, 29(2), 88.
Jackson, D., Hutchinson, M., Barnason, S., Li, W., Mannix, J., Neville, S., ... & Usher, K.
(2016). Towards international consensus on patient harm: perspectives on pressure injury
policy. Journal of nursing management, 24(7), 902-914.
Järbrink, K., Ni, G., Sönnergren, H., Schmidtchen, A., Pang, C., Bajpai, R., & Car, J. (2016).
Prevalence and incidence of chronic wounds and related complications: a protocol for a
systematic review. Systematic reviews, 5(1), 152.
Kaur, S., Singh, A., Tewari, M. K., & Kaur, T. (2018). Comparison of two intervention strategies
on prevention of bedsores among the bedridden patients: A quasi experimental
community-based trial. Indian journal of palliative care, 24(1), 28.

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Li, Y., Yao, M., Wang, X., & Zhao, Y. (2016). Effects of gelatin sponge combined with moist
wound-healing nursing intervention in the treatment of phase III bedsore. Experimental
and therapeutic medicine, 11(6), 2213-2216.
Liang, M., Chen, Q., Zhang, Y., He, L., Wang, J., Cai, Y., & Li, L. (2017). Impact of diabetes on
the risk of bedsore in patients undergoing surgery: an updated quantitative analysis of
cohort studies. Oncotarget, 8(9), 14516.
Liu, M., Yang, J., Yu, X., Huang, X., Vaidya, S., Huang, F., & Xiang, Z. (2015). The role of
perioperative oral nutritional supplementation in elderly patients after hip
surgery. Clinical interventions in aging, 10, 849.
Nguyen, K. H., Chaboyer, W., & Whitty, J. A. (2015). Pressure injury in Australian public
hospitals: a cost-of-illness study. Australian Health Review, 39(3), 329-336.
Rai, S. K., Varma, R., & Wani, S. S. (2018). Does time of surgery and complication have any
correlation in the management of hip fracture in elderly and can early surgery affect the
outcome?. European Journal of Orthopaedic Surgery & Traumatology, 28(2), 277-282.
Seong-Hi, P. A. R. K., & Lee, H. S. (2016). Assessing predictive validity of pressure ulcer risk
scales-a systematic review and meta-analysis. Iranian journal of public health, 45(2),
122.
Wettstein, R., Tremp, M., Baumberger, M., Schaefer, D. J., & Kalbermatten, D. F. (2015). Local
flap therapy for the treatment of pressure sore wounds. International wound
journal, 12(5), 572-576.

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Wilson, W. C. (2015). Pressure Sores: Know What Is Avoidable, Unavoidable. Caring for the
Ages, 16(3), 10-11.