Evidence Based Practice: Pressure Ulcers

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Evidence Based Practice – Pressure Ulcers
In today’s era of nursing, nurses practice in an “accountability age.” The quality of care provided to each patient as well as cost issues is what drives the direction of healthcare. Patients are becoming more informed and knowledgeable about their own health as well as prevalence of medical errors within hospitals and other healthcare institutions across the United States. To decrease such errors such as nosocomial infections, medication errors, pressure ulcers, and even death, health care professionals began to take on new approaches to see what works and what doesn’t. To implement these new approaches nurses must play the role as a leader and work with other staff members to ensure interventions
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In a study to assist nurses at the University of Pittsburg Medical Center in preventing and treating patients with skin impairments the Transformational Care at Bedside (TCAB) Method was implemented (Ackerman, 2011). This method included the use of a dedicated Skin Care Resource Nurse to assist a medical-surgical unit in reducing nosocomial pressure ulcers (Ackerman, 2011).
The TCAB Method included the use of an initial skin assessment (Ackerman, 2011). The admitting nurse would perform a skin assessment of every patient, documenting any skin impairments (Ackerman, 2011). Any skin impairments noted would be photographed, measured, and documented on a designated skin assessment sheet by the nurse. Skin assessment sheets would then be redone on Mondays, if the patient has a change in skin condition, or is transferred to another unit (Ackerman, 2011). If skin impairments were present, the nurse would then treat according to hospital policy and implement the eight steps of skin protocol (Ackerman,
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Either health care staff is not implementing these strategies into their patient’s care or some changes obviously need to be made. Interventions to prevent pressure ulcers consist of using the Braden Scale for initial and repeated skin assessments to determine the patient’s risks for pressure ulcers, specialized support mattresses, heel supports, and frequent repositioning for bed bound patients, encouraging mobility, moisture management, nutrition, hydration, and reducing friction or shear forces on parts of the body at increased risk for pressure ulcers (Sullivan & Schoelles,

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