Evaluating Pressure Injury Prevention Policy for Aged Care Nursing

This essay discusses the Australian pressure injury prevention policy and its role in guiding the nursing of aged care patients. It highlights the increasing rates of pressure injuries, their causes, and the importance of prevention strategies. The policy empowers nurses to understand the causes and risks of pressure injuries, assess injuries correctly, and implement preventive measures such as keeping skin dry and clean, using continence plans, and repositioning patients frequently. The essay also addresses the need for individualized care plans, collaboration among healthcare teams, and continuous monitoring of clinical outcomes. Despite the policy's focus on prevention, the essay acknowledges that pressure injury incidents persist, emphasizing the need for an integrated approach across the healthcare system. It further discusses the relevance and sustainability of the policy, emphasizing the importance of strong leadership and continuous evaluation to address gaps and improve patient outcomes.

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Nursing
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According to the Australian wound management, the rate of pressure injury has been
increasing over the years due to various factors such as new sets of standards, and ignorance
among patients. A pressure injury can be defined as a localized injury to the underlying tissue of
the skin or the skin itself that is usually over bony prominence. This injury usually develops as a
result of friction and shearing forces, pressure, age-related skin, decreased mobility and could
also be because of poor nutrition. It was previously known as bed sore, pressure ulcer or
decubitus ulcer. Many of these injuries are preventable and it is also known that they take a long
period to heal which affects the quality of life of the patients through susceptibility to pain, mood
disturbance, sleep and infections (Erin, 2012). They also have an impact on mobility,
rehabilitation and also a long term quality of life. According to the Australian Department of
Health. (2017), medical practitioners should work together to enable the people understand how
they can prevent themselves from this illness. It also asserts that Pressure injuries prevention is a
responsibility of all health staff regardless of their position or location where they implement
several prevention strategies which are aimed at lowering the risk of pressure injuries aided by
the pressure injury prevention policy created to lower the illness’s rates. However, despite the
prevention strategies, these injuries still occur in aged patients due to the failing skin in the end
stages of their life. In this essay, we shall discuss how this pressure injury procedure policy can
be accessed so as to guide in the nursing of aged care patients in Australia. We shall also
compare the findings in this essay with the up-to-date best practice evidence in Australia.
According to the Nursing and midwifery board of Australia (2016), pressure injury
procedure policy enables the nurses, who play a crucial role in providing care for the pressure
injury patients, and also leading line in prevention, management and assessment of this issue, to
understand pressure injury causes and risks by giving them tools required to assess the injuries

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correctly to ensure that patient outcomes are successful. It also enables intensive care nursing
which reduces complications which improves patient outcomes. Once, pressure injuries were
thought to be unavoidable incidents or occurrences, Emergency Nurses Association stated
otherwise when they claimed that injuries usually follow a predictable pattern which makes them
preventable (Nursing and midwifery board of Australia, 2016). Also, if pressure injuries risk
factors are seen early, instituting appropriate interventions of preventions is the best way to
tackle it. This policy states that keeping the patients skin dry and clean will help a lot in
preventing pressure injuries. It also provides a continence plan for the aged care patients with
incontinence that should be implemented using external or internal urine collection devices.
Pressure injury policy also indicates that, adult briefs should be avoided whenever
possible as they are a source of moisture concealment and retention leading to skin damage, for
aged patients with incontinence, which predisposes them to pressure injuries. There is also
provision for the aged people who barely move when asleep, stating that they should be
repositioned frequently as sleeping in the same position also predispose them to the injuries
(Bliss, 2017). Generally, pressure injury policy ensures that the aged care patients are well taken
care of reducing the occurrence of pressure injuries which they highly prone to due to the skin
failure some of them experience. It also allow nurses to use pressure relieving devices which
supports body weight redistribution but doesn’t negate the need for regular pressure area care as
some of the high risk aged patients who use the pressure relieving devices might pave way for a
decrease in turning frequency overnight to ensure sleeping patterns that are adequate hence it
should be assessed on an individual basis to all the patients in the aged care centre.
Pressure injury policy also establishes the need for the aged patients with considerable
mobility changes to have goals of care which are established by a multidisciplinary team

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collaborating with the caregivers (McInnes et.al, 2015). Also the patients who are receiving
palliative care, especially, should have appropriate goals included in their management plan as
palliative care has a stronger focus to manage comfort, symptoms which improve their quality of
life. Pressure injury policy seeks to help the nurses in aged care centres to improve the
knowledge of the underlying physiology of the pressure injury formation and to recognize
pressure injury factors that contribute to its occurrence. It also helps the nurses identify the aged
patients with the highest risk of getting the injuries, which help them document and implement
prevention and intervention strategies and to also prevent any complications which are associated
with these injuries from arising. These improve the patients quality of life to minimize the risk of
pressure injuries dramatically declines.
Pressure injury policy enables the nurses to conduct a quality-of-life and psychological
assessment, in order to assess pressure injury’s impact on the quality of life of the patients and
their caregivers as well. This assessment will help determine the patient goals, along with the
determination and ability that they have to participate in the care plan. Also states that, when an
aged patient has this injury and is deemed healable, the commitment of the patient and that of the
caregivers is very important in achieving outcomes which are successful and resource-efficient
(Edomonds et.al, 2014). Also, through pressure injury policy, the nurses are able to ensure the
safety of the aged patients by making sure that they make lifestyle choices that will not
predispose them to pressure injuries as lifestyle factors are considered to be very important when
identifying risks involved in the development of pressure injuries. This is because the aged
people have a very high risk of developing pressure given their advancing age. This is due to the
decline of their mental and general nutritional status, decreased mobility, incontinence, sensory
perception deficits and also their skin’s changing characteristics. Therefore, being aware of the

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increasing risks will assist the nurses in targeting high-risk patients for prevention programs
which ends up improving the quality of their lives.
According to Australian Wound Management Association, pressure injuries remains a
health problem that keeps occurring frequently in Australia despite their avoidable nature and
also despite the physical, emotional, financial and social burden they present to the caregivers
and the individual patients. From the perspective of the Australian health system, the high
readmission rate, increased length of stay in the hospital and also the cost of wound management
are burdening as pressure injury care cost is estimated at 14 million dollars annually for the
residential respite and aged care sector in Australia (Miles et.al, 2013). The pressure injury
prevention policy is clearly demonstrable in Australia due to the inclusion of standard 8:
management and prevention of pressure injuries in the Australian National Safety and Quality
Health Service Standards as it appears to contribute to the gradual decline in the prevalence of
pressure injuries in an aged care setting. The clinical guidelines laid out are one of the strategies
that are associated with the improved benefits for the patients and healthcare systems which
includes a decrease in prevalence rates of preventable diseases.
In Australia, the policy is also addressing the care of older adults, individuals who have
spinal cord injury and also those in critical care and palliative care settings. This policy also
focuses on various factors like the support surfaces and also the positioning of aged adults who
can’t move by themselves which prevents pressure injuries. It also recommends that skin
temperature and changes in surrounding tissues consistency be prioritized when skin assessment
is conducted or while classifying pressure injuries. This is also due to the impact of body
temperature and skin moisture which are factors that should be considered during comprehensive
risk assessment as they influence microclimate which increases pressure injury risk. On

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implementation of this policy, it addresses the management and assessment of facilitators and
barriers to its implementation, where it focuses on the organization and facility level strategies
which promote the uptake of the best practices of pressure injury prevention. Pressure injury
policy also addresses the process, outcome and structure indicators of pressure injury
management and prevention strategy (Coleman et.al, 2013). Lastly, this policy addresses the
caregivers and the aged patients recommending on the responsibilities of the patients in ensuring
that they get optimal care.
Pressure injury policy is still relevant as it has created sustainability of an individualized
prevention maintenance or protocol of a healed injury which depends on access to appropriate
services and equipment in collaboration with the individual with a high risk of pressure injury,
service providers, caregivers and the healthcare professionals. This is because the successful
sustainability of the policy programs is dependent on strong management and leadership skills so
as to identify the injury prevention as a key priority so as to ensure optimal outcomes. Also,
goals of care such as quality-of-life issues, wound closure and also symptom control might not
occur until underlying causes of pressure injury is optimized hence the importance of pressure
injury policy which recommends, assess, potentially revises and also re-evaluates the treatment
plan so as to address the gaps for modification (Allman et.al, 2015). Also by using validated
tools, prevention and treatment plan goals can be determined by the clinicians. This is because
pressure injury prevention is the ultimate goal.
The importance of working using the up to date practices is because they are supported
by the best evidence available where the policy’s implementation will require patient level
reflection and also considering resources available, clinical circumstances and the patient-
clinician relationship, or nurse preferences. It also helps on reflecting direct clinical evidence

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paucity by addressing the aspects of treatment and the prevention of pressure injuries (Junkin
et.al, 2017). The policy provides for extensive guidance in the areas of interest and also contains
a more comprehensive address on management and prevention of pressure injuries in populations
with special interest like aged care setting. Also, the policy recommends the application of
polyurethane foam dressing by bony prominences which minimize the exposure to shear and
friction forces. The best quality of evidence that supports these was gotten from a recent study in
Australia that suggested that, in selecting a prophylactic dressing, its impact to microclimate
should be given much consideration as it helps in preventing pressure injuries due to the
continued skin assessments.
Pressure injury policy is of paramount significance. But despite the focus on prevention,
pressure injury incidents in aged care patients haven’t significantly decreased. This shows that an
integrated prevention approach is required across all health care system areas in Australia so as
to make a difference in the incident rates. For optimal effectiveness and acceptance, the
integrated teams should include other departments such as housekeeping, the patients and their
families. According to the Australian department of health (2017), several strategies such as
liaising with case managers and planning care and regular contracts can aid in addressing chronic
health issues such as pressure injuries in aged care setting. Additionally, communication and
collaboration across all the sectors and departments are crucial to ensuring that the outcomes are
optimal and patient-centred for the management and prevention of pressure injuries in these
patients. In all injury management or prevention cases, customized care plans should be
implemented. Monitoring clinical outcomes is crucial to driving practice and culture changes
necessary to manage and prevent pressure injuries. Implementation of this policy and identifying
the facility barriers to resolve these issues is imperative in supporting the changes required.

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Pressure injury policy have been recognized as a quality measure in Australia in both hospitals
and long-term care and hospital pressure injury rates, nationally, are being reported and are also
facilities being named. Time has come to ensure the prevention of pressure injuries becomes a
key component in all aspects of safe patient care.

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References
Allman, R. M., Goode, P. S., Burst, N., Bartolucci, A. A., & Thomas, D. R. (2015). Pressure
ulcers, hospital complications, and disease severity: impact on hospital costs and length
of stay. Advances in wound care: the journal for prevention and healing, 12(1), 22-30.
August, D. L., Edmonds, L., Brown, D. K., Murphy, M., & Kandasamy, Y. (2014). Pressure
injuries to the skin in a neonatal unit: fact or fiction. Journal of Neonatal Nursing, 20(3),
129-137.
Australian Department of Health. (2017). Best-practice examples of chronic disease
management in Australia. Retrieved from
http://www.health.gov.au/internet/main/publishing.nsf/content/health-care-homes-best-
practice
Australian wound management. Wounds Australia responds to the new edition of the national
safety and quality health care standards. Retrieved from.
http://www.woundsaustralia.com.au/pages/wac.php
Bliss, M. R. (2017). Pressure injuries: causes and prevention. Hospital medicine : 2017), 59(11),
841-844.
Coleman, S., Gorecki, C., Nelson, E. A., Closs, S. J., Defloor, T., Halfens, R., ... & Nixon, J.
(2013). Patient risk factors for pressure ulcer development: systematic review.
International journal of nursing studies, 50(7), 974-1003.
Erin, T. (2012). Illness as Narrative. Composition Studies, 40(2), 45-50
Junkin, J., & Selekof, J. L. (2017). Prevalence of incontinence and associated skin injury in the
aged care patient. Journal of Wound Ostomy & Continence Nursing, 34(3), 260-269.

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McInnes, E., Jammali‐Blasi, A., Bell‐Syer, S. E., Dumville, J. C., Middleton, V., & Cullum, N.
(2015). Support surfaces for pressure ulcer prevention. Cochrane Database of Systematic
Reviews, (9).
Miles, S. J., Nowicki, T., & Fulbrook, P. (2013). Repositioning to prevent pressure injuries:
evidence for practice. Australian Nursing and Midwifery Journal, 21(6), 32.
Nursing and midwifery board of Australia. (2016). Enrolled nurse standards for practice.