Skin Care: Hospital-Acquired Pressure Ulcers

Introduction

Skin care is an important part of ensuring quality health for individuals in the community. Health workers will usually advise patients on the various ways of protecting their skin from infection or possible damage. There are many people who have problems associated with their skin and as such, require assistance from the medical practitioners. Skin care is performed in routine on a daily basis to prevent occurrence of injuries or dermatitis. Through caring for skin, a person is able to enhance appearance for cosmetic purposes. Skin protection begins as early as birth all through to death. There are vast routines that exist in the current society. However, the occurrence of injuries and other diseases may cause significant issues that will require professional attention from health workers. The following paper discusses ways in which health workers could help prevent and treat pressure ulcers acquired from hospital. 

Summary

The article by Armour-Burton, Fields, Outlaw and Deleon (2013) attempt to provide nurses with an effective method of ensuring fewer days of hospitalization for the patients by preventing the hospital-acquired pressure ulcers. These are serious clinical complications that affect the patients in a hospital where in some cases result in high levels of pain, duration of stay and death of a patient. The cost of care in the US has been on a steady rise for quite some time while the patients would like to spend less. As a result, members of the medical community are required to develop ways in which patients will incur lower costs in treatment. Improving the quality of care provided to the patient is one way of ensuring these costs are reduced to a minimum. Since October 2008, the Centers for Medicaid and Medicare Services stopped providing funds for making payments on various hospital-acquired infections or disease. Stage III and IV of pressure ulcers are some of the conditions that the government funded agencies will not fund. 

The authors employed a comparison design that would look into approaches that nurses have implemented to prevent such complications. The Healthy Skin Project was developed by the surgical progressive care unit (PCU) at Sharp Grossmont Hospital in San Diego. Three major components were involved in its development: a wound liaison nurse in each unit, education of the nurses and involvement of nurse assistants. This study compared the prevalence of hospital-acquired pressure ulcers between 2003 and 2006 before the development of the intervention plan and through to 2011 after the skin care intervention was implemented. Out of the 20 quarters used in the research 17 of them were able to reduce the prevalence of the complication from 18.92% to 0.0%. This data is a clear indicator that the Healthy Skin Project is an appropriate measure that practicing nurses could implement in improving quality care provided. 

Use in Nursing Practice

The research at hand looks into at the techniques that nurses at the (PCU) at Sharp Grossmont Hospital applied in before the development of the Healthy Skin Project. The patient’s primary nurse would undertake the role of guiding nursing assistants with prevention of the pressure ulcer. These practitioners had to rely on their own knowledge and significant experience of the skin problem. This practice involving assessment and treatment usually resulted in recording the patient’s risk for pressure ulcers once a shift (Armour-Burton, Fields, Outlaw, & Deleon, 2013). This information would help the nurse to come up with a treatment plan where the latter would require consultations from the team of medical workers attending to the patient. Though this approach was effective in ensuring the cure for patients it was recognized as a reactive and curative method rather than a proactive and preventive one. In this regard, the Healthy Skin Project provides detailed information on ways to ensure pro-action and prevention practices. 

Prior to the project, the wound liaison nurse was not an established position. As a result, it was created as an effective means of ensuring the most qualified nurse in practice is involved in the prevention process. He or she is required to devote 24hrs in a month to this role whereby the advanced knowledge is not just drawn from personal experience but also through seminars, participating in assessment and treatment of compromised skin with the wound team and completing significant courses (Armour-Burton, Fields, Outlaw, & Deleon, 2013). Consultation with a hospital-based wound nurse and the entire wound team was incorporated to ensure an effective means of ensuring prevention. The Healthy Skin Project was seen as an appropriate intervention as it ensured a systematic means of developing measures of preventing pressure ulcers in the hospital. It is evident that the health workers would also develop a similar system of applying measures of ensuring quality care for the patients in the hospital 

Ethical Considerations

In every measure of administering clinical interventions for ensuring quality care for patients, it is important to take into consideration the acceptable ethical practices of the health workers. Within the Healthy Skin Project, the use of a wound liaison nurse is recognized as an appropriate measure of ensuring a qualified nurse is responsible for developing preventive measures and changing techniques that nurses applied in administering to patients in the hospital. Unlike the previous practices where the primary care was required to rely on their knowledge of assessment and treatment of compromised skin, the wound liaison nurse has received the appropriate training for such situations (Rafter, 2011). Attendance of numerous education seminars, completion of training courses and practical assessment sessions are all effective in ensuring the nurse receives an greater amount of knowledge. This intervention plan is also appropriate as it ensures that inexperienced nurses do not make mistakes when attempting to treat pressure ulcers (Rafter, 2011).

The Healthy Skin Project also requires the education of other nurses and the involvement of nursing assistants. This approach is ethical as a team of qualified professionals are all involved in improving the quality of care provided in the hospital. The admitted patient is less likely to suffer from hospital-based pressure ulcers as there is a whole team of professionals who have dedicated their time and effort to ensure such complications do not develop (Spetz, Brown, Aydin, & Donaldson, 2013). This team will also receive training during the implementation of the intervention as they seek to increase their knowledge on attending t compromised skin. In this regard, skin care provided within the hospital is at the highest level.

References

Armour-Burton, T., Fields, W., Outlaw, L., & Deleon, E. (2013). The Healthy Skin Project: changing nursing practice to prevent and treat hospital-acquired pressure ulcers. Critical care nurse , 33(3), 32-39.

Rafter, L. (2011). Evaluation of patient outcomes: pressure ulcer prevention mattresses. British Journal of Nursing , 20(11), 32.

Spetz, J., Brown, D. S., Aydin, C., & Donaldson, N. (2013). The value of reducing hospital-acquired pressure ulcer prevalence: an illustrative analysis. Journal of Nursing Administration , 43(4), 235-241.