Research Paper Example on Pressure Ulcers

In medical institutions, especially in care homes, it is common for elders to develop pressure ulcers (PU). Elderly clients are at greater risk of developing these skin conditions due to complications in their health. Health care workers actively collaborate to initiate preventative tactics. Pressure ulcers are categorized based on severity, classified as stage I-IV and unstageable (Anaba-Wright & Kefas, 2020). Discussion of appropriate interventions can delay tissue damage and prevent degeneration. The purpose of this is to promote the overall health, well-being, and quality of living in elderly clients (Macedo et al., 2016). In connection with the three articles, I will be discussing the similarities, differences, and reflect my own opinion on prevention strategies against PU. 

Pressure Ulcers and its Prevention Strategies 

Pressure ulcers are localized tissue damage resulting from sustained pressure commonly present in areas of bony prominence (Nadykkandiyil et al., 2020). Consequences and symptoms of PU include pain, discomfort,  lengthen healing, costly and reduced quality of life (Nadykkandiyil et al., 2020). This typically rises in elderly patients from prolonged bed rest or restricted in a wheelchair, influenced by friction, shear, humidity, and immobility (Nadykkandiyil et al., 2020). This can be physically and mentally exhausting for the patient, especially if it progresses into severe cases and become challenging to manage. Solutions to preventing pressure ulcers include repositioning the body every 2 hours, adequate body hygiene and moisturization, maintaining a healthy diet, and daily skin inspection (Macedo et al., 2016). Nadykkandiyil et al. (2020) state, “Preventative strategies for pressure ulcers begin with the identification of high-risk persons, appropriate allocation of resources, and adequate techniques of pressure relief.” Maintaining this perception will provide quality care and monitoring within elder institutions. 

Article Analysis 

The three articles that I am referring to are Nadykkandiyil et al. (2020), Anaba-Wright and Kefas (2020), and Macedo et al. (2016). Nadykkandiyil et al. (2020) conducted a study of 90 patients from acute Geriatric care at Hamad General Hospital in Qatar with a sample of patients with and without pressure ulcers. The study was conducted to understand internal factors that can impact the development of skin infections, demonstrating the relationship between demographics, clinical characteristics, and risk factors (Nadykkandiyil et al., 2020). As a result, early interventions in care can lessen the risks of developing pressure ulcers in frail elders. 

Anaba-Wright and Kefas (2020) focus their study on the importance of providing education of characteristics of ulcers, providing individualized patient care, and accurately identifying early stages to promote avoidable situations of pressure ulcers. They developed a training program called, 'Wound Wednesday,' which was conditioned for care workers and families to strengthen their knowledge of ulcers (Anaba-Wright & Kefas, 2020).

Macedo et al. (2016) study the importance of empirical indicators to evaluate instruments concerning the prevention strategies of pressure ulcers in elders. Maslow's hierarchy of needs and incorporating psychobiological, psychosocial, and psycho-spiritual aspects distinguished relevance to preventing pressure ulcers (Macedo et al., 2016). The few indicators mentioned in the article included hypertension, nutrition, sleep, and thermoregulation can benefit in determining preventative measures (Macedo et al., 2016).  

Article Similarities 

The most prominent similarity in each article is the importance of acquiring education and knowledge of the stages of ulcers, the different risk factors, and understanding the physiological aspect. This applies towards healthcare providers however, families too can contribute to this information. This is strongly talked about by Anaba-Wright and Kefas (2020) as it was their main concern of how many care workers in residential care homes lack training. Likewise, Macedo et al. (2016) mention how educational implications provided for the elderly, caregivers, family members, and society enunciate the purpose of self-care, direct focus on measures, monitoring, and effective management. Nadykkandiyil et al. (2020) engage that understanding the pathophysiological aspect of pressure ulcers is crucial in determining avoidable and unavoidable situations. Interpretation on immobility, tissue ischemia, and undernutrition is beneficial in formulating treatment plans (Nadykkandiyil et al., 2020). 

Article Differences 

Although each article aligns with the topic, there are differentiation characteristics between the three articles. Choice of the sample population, the structure of the study, and its results portrayed contrasting features. Nadykkandiyil et al. (2020) researched elderly patients that were Qatari National and older than 65 years of age. They sampled patients with developing pressure ulcers and those without, to conduct a comparative analysis of the various underlying factors that were significant in each sample. They discovered that patients with pressure ulcers display higher risk factors compared to those without. They found that advanced age, ethnicity, BMI, physical impairments, cognitive impairment, and urinary or fecal incontinence affect the evolution of pressure ulcers in elders (Nadykkandiyil et al., 2020) Conversely, Anaba-Wright and Kefas (2020) performed research on 35 staff members from two residential homes by conducting a survey on their knowledge of pressure ulcers, followed by a training program to educate them on analyzing, identifying, and caring pressure ulcers in care homes. As a result, participants came out of the informal training feeling more confident and knowledgeable. Macedo et al. (2016) gathered nine health professionals who work with wound/skin treatment to organize a methodological study. They gathered eight nurses and one physiotherapist teacher who either had a master’s degree, were doctor specialists, professors of Elderly health, etc (Macedo et al., 2016). The study was organized into 3 steps: “1. Identification of empirical indicators through literature; 2. Validation of empirical indicators for the judges; 3. Structuring the first version of the instrument” (Macedo et al., 2016). The purpose of this study was to structure a theoretical framework to apply empirical indicators, criticize them by categorizing them by relevance and determine an instrument to initiate appropriate care planning and nursing interventions (Macedo et al., 2016).

Opinion

With much thought and consideration, I believe that elderly clients are at greater risk of pressure ulcers and should be advised in the early stages to reduce the risks of infection. The decline in elderly health increases the development of many health conditions like loss of elasticity in the skin, atherosclerosis, and atrophy in the muscles. The incorporation of age-related factors, the environment, and current health conditions are significant in identifying the early stages of PU. As mentioned in the articles, internal and external factors of the elderly can contribute to lessening the severity of PU or even prevent it from developing. Pressure ulcers can develop into deep and more painful tears, prolonging the healing process and worsening conditions. 

Conclusion

Pressure Ulcers in elders are preventable and treatable with appropriate guidance and techniques. Through collaboration, nurses and healthcare workers can apply proper assessments, planning, and interventions to prevent the uprise of skin conditions related to various risk factors. Due to skin vulnerability in elders, precaution measures and observations serve as a main priority. Education is a key component discussed in all three articles demonstrating how knowledge and understanding of pressure ulcers are effective during treatment. This demonstrates the importance of receiving educational training, effective monitoring, understanding risk factors of ulcers, and the pathology for prevention strategies. Nadykkandiyil et al. (2020) study analyzed various components of patients with and without pressure ulcers and discovered the risk factors associated with each sample size. Anaba-Wright and Kefas (2020) compared the effectiveness of their training program, ‘Wound Wednesday’, and addressed the significance of receiving skills in this field. Macedo et al. (2016) conducted a methodological study to validate the reliability of different instruments in preventing pressure ulcers in older patients. Overall, due to the higher exposure of PU in the elderly community, considering the risk factors associated with their health and advising early interference would greatly contribute to reducing the development of pressure ulcers in elders.