Clinical Audit of Nursing Practices for Pressure Ulcer Prevention

This assignment focuses on the prevention and management of pressure ulcers, commonly known as bed sores, within healthcare settings. It highlights the importance of optimal care standards due to the prevalence of pressure ulcers in patients with long-term illnesses or immobility. The report covers the background of pressure ulcers, their causes, and methods of evaluation, including the Braden Scale and AHRQ guidelines. A mixed-method clinical audit was conducted, involving interviews with patients, nurses, and family members, along with online questionnaires and case note reviews. Data analysis included percentage calculations, mean and median mode analysis, and thematic analysis of interview transcripts. The study emphasizes the need for knowledge translation in nursing practices to improve wound care and reduce the occurrence of pressure ulcers, particularly in patients receiving long-term or palliative care, advocating for the use of evidence-based practices like the Braden score to assess risk factors.

PRESSURE ULCER
PREVENTION

INTRODUCTION
 The assignment focuses on the
particular aspect of the
prevention and management
of bed sores or pressure ulcers.
 This could be attributed to lack
of optimal care standards and
procedures within a health
care setting.
 The bed sores or the pressure
ulcers are common in case of
patients suffering from long
term sickness or lying down for
a very long time (Sadeghi et al.
2015).

BACKGROUND OF THE STUDY
 Bed sores are formed due to limited blood supply
to a part of the skin (Stansby et al. 2014).
 causes reddening of the skin along with
development of scars or skin shedding.
 changes observed in the texture or the colour of
the skin.
 Additionally, pus like drainage along with
swelling, irritability and warming of the areas are
also observed in pressure ulcers (Sawatzky et al.
2017).

CONTD..
 As commented by Yost et al.
(2015), the degree of skin or
tissue damage ranges
unbroken skin to deep muscle
and bone injury
 The degree of infection further
increases with non-movements
in the patient (Santamaria et
al. 2015).

CONTD..
 Reports and estimates have show that no less
than 8% of all hospital patients have
experienced bed sores at one point of time or
the other.
 On the contrary, a further higher percentage of
cases of pressure ulcers have been noticed in
patients receiving care within their own home
set ups (Patiraki et al. 2017)

STANDARD OF EVALUATION
 The uses of pressure ulcer prediction tools such
as the Braden Scale have been a landmark
development
 Applications of the Agency for Healthcare
Research and Quality (AHRQ) guidelines have
been seen to reduce the incidents of pressure
ulcer development (ahrq, 2017).

CONTD…
 weekly assessments of
the pressure ulcers
 For the assessment of the
pressure ulcers location,
size, colour of the wound,
the amount of exudates,
odour, nature or the
frequency of pain are
important governing
factors (ncbi, 2017)
 second stage is the
assessment of the extent
of tissue damage caused

CONTD..
 Lack of sufficient knowledge in the nursing
professionals regarding identification of all stages of
pressure ulcers could be a plausible hindrance
 The uses of the Barden Scale have been found to be
of relevance in assessment of the pressure ulcer
conditions in the patients (Berkman et al. 2017).
 The Braden scale consists of six measurement
parameters based upon which the assessment is
conducted such as – sensory perception, mobility,
moisture, activity, nutrition and friction or shear.
 The score can range anywhere 6-23; however, a
lesser score generally means potentially higher risk
for an individual (ncbi, 2017)

SAMPLING METHODS
 For the process of clinical audit a mixed method
was followed
 10 people were interviewed including the patients,
registered nurses and respective family members
regarding their conditions and management of bed
sores.
 Apart from that online questionnaires were
generated for collecting responses related to
affective pressure ulcer and would management
(Santamaria et al. 2015)
 Fewer case notes had also been taken into
consideration for making the study on pressure
ulcers

CONTD..
 qualitative assessment
was conducted in order
to analyse the responses
of the patient and their
respective families
 the privacy norms also
needs to be maintained
during the process of
recording individual
patient responses (Pigott
et al. 2017).

CONTD..
 Pamphlets could be distributed in the waiting
room inviting the family members of the patient
to participate in the online discussion.
 Furthermore analysis of the nurse notes along
with the observation charts or the medication
charts can further help in assessment of the
nursing practices with regards to management of
the conditions of pressure ulcers (Berkman et al.
2017)