Educational Presentation

1. BY ALADE BISOLA

2. BACKGROUND There is an urgent need for healthcare providers practicing at the facility to reduce the current rate of pressure ulcers among the residents. The weekly skin assessments indicate that, on average, 5 in 20 residents have pressure ulcers. This means that the incidence rate of pressure ulcers in the facility is 25%. The 25% incidence rate by far exceeds the 8.5% incidence rate, which is the national average for home health agencies (Anthony et al., 2019). Hence, the staff members should note that the facility is performing poorly compared to its peers when it comes to pressure ulcer prevention. Mauris posuere eu risus at iaculis

3. WHY THERE IS A NEED TO REDUCE THE CURRENT RATE OF PRESSURE ULCERS  Pressure ulcers have a negative impact on patient outcomes since it leads to low levels of patient satisfaction and the risk of hospitalization due to the following effects; Pain and discomfort Cellulitis: An infection of the skin. Osteomyelitis: An infection of the bone. Bacteremia: An infection of the blood. Meningitis: An infection of the brain and spinal cord. Endocarditis: An infection of the heart.

4. PSYCHOLOGICAL IMPACTS OF PRESSURE ULCERS  The need to prevent pressure ulcers among the residents, is not only related to medical effects, but also to the psychological impacts. The wounds caused by pressure ulcers, particularly the visible ones, often lead to psychological trauma due to feelings of shame and embarrassment. Furthermore, according to Charalambous et al. (2018), pressure ulcers are a major stressor among patients since they lead to restriction of daily activities, as well as are associated with pain and ulcer odor. Hence, the occurrence of a pressure ulcer constitutes a major psychological and physiological burden that reduces the quality of life and leads to increased stress among the affected individuals.

5. THE RESIDENTS THAT ARE AT A HIGHER RISK OF PRESSURE ULCERS It is important for the staff members to be aware of the residents at the highest risk of developing pressure ulcers so that more preventive strategies can be implemented for these individuals. Such individuals include; Those with a limited amount of mobility or a total inability to move, such as the residents using wheelchairs and the bedridden ones (Chung et al., 2022). Those with prosthetic limbs. In this case, if the device does not fit properly, the skin can be irritated and a pressure injury can develop.

6. THE RESIDENTS THAT ARE AT A HIGHER RISK OF PRESSURE ULCERS Other at-risk individuals include; People with a loss of sensation: They are at risk because they may not feel the pressure being applied to the skin. As a result, they may not move, which could worsen the damage (Chung et al., 2022). Those with malnutrition: Wound healing is slowed when nutritional needs are not met. The elderly: As people age, the skin naturally becomes thinner and this makes them more susceptible to pressure ulcers.

7. CAUSES OF PRESSURE ULCERS    It is important for the staff members to understand the various causes of pressure ulcers. This understanding will enable the staff members to mitigate the causes. Some of the main causes of pressure ulcers are; Pressure from a hard surface, such as a bed or wheelchair. Pressure that is placed on the skin through involuntary muscle movements, such as muscle spasms (Chung et al., 2022). Moisture – which can break down the outer layer of the skin (epidermis).

8. COMPREHENSIVE SKIN ASSESSMENT Undertaking comprehensive skin assessments is one of the evidence-based strategies for reducing the current rates of pressure ulcers at the facility. Comprehensive skin assessment is a process by which the entire skin of every individual is examined for any abnormalities. It requires looking and touching the skin from head to toe, with a particular emphasis over bony prominences.

9. CONTINUATION The benefits of undertaking a comprehensive skin assessment include; It assists in identifying any pressure ulcers that may be present. It assists in identifying the individuals at risk of pressure ulcers, based on the level of skin integrity. For instance, the presence of skin discoloration or rash means that an individual is at a higher risk of pressure (Agency for Healthcare Research and Quality, 2018). Hence, the need to implement the relevant preventive measures. Furthermore, another risk factor for pressure ulcers that can be detected during the comprehensive skin is excessively dry skin.

10. CONTINUATION There is a need to change the current practice, in which skin assessments are undertaken weekly. According to the Agency for Healthcare Research and Quality (2018), individuals who are at risk of pressure ulcers require daily comprehensive skin assessment. In fact, the agency recommends that where possible, comprehensive skin assessment should be undertaken in every shift as part of routine care. The routine assessment would lead to timely detection of individuals who are about to develop pressure ulcers, so that the sores can be intervened on before they affect the deeper tissue.

11. SKIN INSPECTIONS  Factors such as tight schedules may prevent the staff members from undertaking comprehensive skin assessments. In such scenarios where comprehensive skin assessments might be impossible, the providers are encouraged to undertake skin inspections. Routine skin inspections are encouraged in the following instances; If the patient is on bed rest, look at the back of the head during repositioning (Agency for Healthcare Research and Quality, 2018). When positioning pillows under calves, check the heels and feet.

12. CONTINUATION Furthermore, skin inspections are also encouraged in the following instances; When checking IV sites, check the arms and elbows. Each time one lifts a patient or provides care, one should look at the exposed skin, especially on bony prominences (Agency for Healthcare Research and Quality, 2018). Examine the skin under equipment with routine removal such as restraints.

13. THE RECOMMENDED APPROACH FOR SKIN ASSESSMENT AND INSPECTION   Furthermore, skin inspections are also encouraged in the following instances; When checking IV sites, check the arms and elbows. Each time one lifts a patient or provides care, one should look at the exposed skin, especially on bony prominences (Agency for Healthcare Research and Quality, 2018). Examine the skin under equipment with routine removal such as restraints.