Hospital Acquired Pressure Ulcers

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Abstract
Hospital Acquired Pressure Ulcers (HAPUs) are an epoch-making healthcare predicament globally. HAPU increases the time duration that a patient is admitted in hospital and simultaneously increases their complications, pain, suffering, morbidity and mortality, and healing process. It also takes a toll on the healthcare costs which has been estimated to amount to 2.2 to 3.6 billion dollars annually. Insurance provider reimbursement has significantly grown to be dependent on the outcome of patients especially since HAPUs is perceived to be an outcome of poor standards of nursing. Clocking 2008, stage three and stage four pressure ulcers are not reimbursable prompting healthcare organizations? effectuation of pressure ulcer prevention criteria and interventions to curb HAPU formation. Recent affirmation portrays that there are varied levels of success when employing soft silicone foam bordered dressings as an adjunctive inhibition therapy for pressure ulcer emergence.
Madeline Leininger?s Transcultural Nursing Theory disseminates that in the process of devising a nursing procedure for a patient, nurses need to take into consideration the cultural background of the patient. Cultural values and beliefs as a frame of reference have a principle impact in the life of the patient. The nurses also need to take into account the patients social life and environment when dealing with the disease (Ray 2016). Being knowledgeable of the patient?s cultural background is advantageous in pinpointing the source of the pressure ulcers and impede future occurrence.

Another vital factor that assists in limiting pressure ulcers is the knowledge from Health as Expanding Consciousness. Margaret A. Newman expounds that human is unitary and cannot be divided into parts. Insight into the patient?s pattern is utilitarian for convalescence and disease prevention (Alligood, 2014). Broadening consciousness in every aspect of the patient is a key step towards minimizing pressure ulcers. This is because the nurse will employ suitable prevention methods relying on the patient?s condition.
Referring to the Holistic Nursing Framework, the healing procedure needs to emphasize on the individual as a whole. A pressure ulcer is a malady that influences the skin and tissue of the patient. A more effective way of limiting the spread of the pressure ulcer pertains to applying oneself to the interconnectedness of the mind, spirit, body, emotions, relationships and the environment (Papathanasiou, Sklavou, & Kourkouta, 2013). Being informed about the medical history of the convalescent, affected by pressure ulcers can beneficial in limiting its occurrence.
Professional nursing practices and how they can assist in limiting pressure ulcers has been well disseminated through Transcultural Nursing, Health as Expanding Consciousness, and Holistic Nursing theories. All affairs pertaining to the patient should be focused on establishing a nursing plan for a patient afflicted with pressure ulcer. The procedure should guarantee that the cause is determined and the possibility of it reoccurring in future is averted after the nurse has closely examined the patient (Papathanasiou et al., 2013). This paper designs a clinical project proposal using the scientific method to develop an evidence-based project to improve patient outcomes.

Introduction
Pressure ulcers are afflictions that occur on a patient?s skin and tissues when the body parts are put under pressure. They can also be referred to as bedsores since they affect convalescence?s that are bedridden hindering blood from flowing to the skin (Lyder, 2003). Since the section under pressure is not receiving any blood, it is lacking oxygen as well as nutrients resulting to the cells dying and formation of a wound. These afflictions can bring about issues that are life threatening, especially to cases such as musculoskeletal dysfunction, diabetes and disorders of the autonomic nervous system. Remedy of the wounds involve applying creams, dressings and in some cases surgery if need arises.
History and Problem Background
Body sections that cover bony areas are the ones prone to be affected by pressure or decubitus ulcers. These parts include the buttocks, hips, heels, back, ankles, among other areas of the body (Singh, Armstrong & Lipsky, 2005). They commonly occur to patients with disabilities, elderly patients, patients who are bedridden and those with sensitive skin. Pressure ulcers come about in phases, it commences with the manifestation of a reddish patch on the section that has been affected or discoloration of the skin. The afflicted section may appear darker, white or contain a purple color. The second phase has the skin opening up and death tissues forming around the wound and it appears pinkish. In some instances there is presence of fluid filled blisters (Singh, Armstrong & Lipsky, 2005). In the third stage, the lower layers of the skin are affected, there is presence of pus in the wounds and it is concave. The fourth phase of pressure ulcers is very critical. This is due to the severity that muscles and bones are affected and there is a dark matter called eschar on the sore. Once it has gotten to this level, it is considered unstageable. It manifests itself green or yellow with pus and it needs dedicated care to recuperate it. It is an established fact that the genesis of ulcers is due to a patient lying on one section of the body for a long period of time applying pressure on the skin. Abrading skin against a rough surface or object generates friction which harms the skin area. Donning soiled garments or clothes for a long period of time may cause irritation that facilitates the wounds on the skin to open. The manifestation comprise of discoloration, vitiation and softening of the skin which is accompanied by infections and pain. The end solution for sores that have become critical is to undergo surgery to reconstruct the damaged part.
Statistics do not account for patients who suffer from pressure ulcers at home since they do not report it to relevant officials. Individuals who suffer from pressure ulcers while at the hospitals have their cases documented and the data is used for analysis and comparison contrast to those who recuperate at home. Due to this limitation the actual and approximate statistics of cases pertaining to pressure ulcers is not entirely canvassed.

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