Prevention Methods for Pressure Injuries in the Elderly
Introduction
It seems reasonable to state that pressure injuries are a considerable issue within the scope of the elderly’s health. There has been a significant number of investigations related to the topic. A plethora of scholars from the medical dimension dedicates their efforts to the identification of the best prevention methods in this vein. Thus, there is the necessary degree of evidence that can be used in the framework given.
The prevention of pressure injuries implies a notable variety of related measures. Hence, it may be relevant to determine the crucial ones and describe them. This paper aims to define possible solutions to the problem of prevention of pressure injuries. The discussion below will be grounded on evidence-based studies and investigations. This is likely to ensure the validity and reliability of the research.
Problem
The threat of pressure injuries is relevant when the patient has a circulatory disorder for more than two hours. The fact is that human tissues and organs are saturated with oxygen by means of capillaries with very elastic walls. Their squeezing, which inevitably occurs when the patient is sitting or lying, leads to a slowdown and sometimes complete cessation of blood flow. In this case, the prevention of pressure sores is an integral part of the treatment process. Improper patient care can also aggravate the situation (Spruce, 2017). However, correct and attentive care is an important condition for the prevention of bedsores in bedridden patients to be carried out correctly. Regarding pressure injuries, it must be remembered that among this contingent of patients, there are those who belong to the group of increased risk of bedsores. These individuals who are malnourished are fluid deficient; patients with overweight, or, on the contrary, with its deficiency. Here, it should be emphasized that this issue is most common among the elderly, which, again, justifies the relevance of the topic.
In a significant number of cases, pressure injuries should be considered complications due to inadequate care. Among other things, these pressure injuries are serious because they are the entrance gate for infection, which can lead to the development of wound infection and sepsis (Walia et al., 2016). Their formation occurs gradually; first, a patient may complain of pain in the lumbar region. Visually, at the beginning, redness, and cyanosis appears on the surface of the skin in places of tissue compression, and edema of the skin develops due to stagnation of venous blood. This is a reversible stage in the development of a pressure injury when the elimination of the squeezing factor and the minimum amount of treatment allowance normalize changes in the skin.
During the development of necrosis, local therapy is aimed at drying necrotic tissues. At this phase, the utilization of ointment and wet dressings cannot be accepted. When there is the rejection of the scab from the pressure injury and filling the wound cavity with granulations, ointment dressings are used (Alderden, et al., 2017). In addition to local therapy, intensive, high-quality treatment of the underlying disease, the use of stimulating and detoxification therapy should be carried out. In order not to allow such a severe state of affairs, it is important to undertake prevention measures in the framework of pressure injuries in the elderly.
Search Strategies
In order to assess the sources of evidence found, there must be a series of elements present that would define them as credible. Many tools exist to help writers and researchers evaluate articles found online. In a recent article by the Kansas State University Library, they stated that to access credibility, it is important to use the Big 5 criteria (KU Libraries, 2016). The first element in the Big 5 criteria is to check the currency or publication date; this will help you decide whether the article is current enough for the topic at hand. The next element is relevance, which means considering the article and seeing if it covers the topic. The third element is authority, and it stands for the credentials of the author. One must examine their level of expertise and knowledge about the subject that you are researching. The fourth element is Accuracy, and it means considering if the source presents accurate information, and most importantly, verifiable information. The last element is Objectivity (purpose). In this last step, one must consider the author’s purpose for creating the source and consider how that affects its usefulness to the research at hand.
Many electronic databases are available for students looking to find adequate research material. These include PubMed, google scholar, and the school’s library resource center. All of these are known as great search engines for research studies. They are easy to navigate and have many articles that are relevant to each other. Most will also include a citation that will help with avoiding plagiarism (KU libraries, 2016). The electronic database that was found to be more user-friendly is Google Scholar. The words that could be used in this site would include prevention, bedsores, training, skilled nursing homes, and the elderly population.
Level of Evidence
It should be claimed that the levels of evidence that were found to support the study were III, IV, and V. Despite the fact that the academic dimension provides several investigations on the theme of pressure injuries that may be considered as I and II levels of evidence, they do not seem relevant to the aim of the study. Sources that give data regarding particularly the prevention measures and the issue’s essentials belong to the levels III–V. However, they remain reliable and peer-reviewed, which is important. The chosen studies allowed the provision of the appropriate solutions.
Level V is evidence from systematic reviews, as well as descriptive and qualitative investigations. The following used articles refer to this level. Alderden et al. (2017) provide a systematic review of risk factors for pressure injuries among critical care patients. Then, Walia et al. (2016) systematically review the effectiveness of monitoring devices in support of the prevention of pressure injuries. These two articles serve as a great theoretical background to the topic.
Level IV means evidence from case-control or cohort studies. Kayser et al. (2018) examine the prevalence and essentials of medical device-related pressure injuries in a considerable, generalizable database, which implies the appeal to a noticeable cohort. Then, Spruce (2017) studies the theme of the prevention of perioperative pressure injuries, appealing to a concrete sample – the perioperative patient population. Finally, Schwartz et al. (2018) provide effects of humidity on skin friction against medical textiles as related to the prevention of pressure injuries, using a quasi-experimental approach, which implies Level III.
Literature Review
The article Risk factors for pressure injuries among critical care patients: A systematic review is current because it was published in 2017, which means it is just five years old and provides current information on the topic. This article adequately covers the top of pressure injuries as it provides information on risk factors for pressure injuries among critical care patients as they are exposed to the medical devices so much (Alderden et al., 2017). The authors, Alderden, Rondinelli, and Cummins, are registered nurses, while Whitney is an associate clinical professor. All the nurses are therefore well versed with the knowledge of pressure injuries as they are professionals in the medical field. The article provides accurate and verifiable information on the risk factors for pressure injuries as the method of data collection and analysis is globally accepted. The purpose of the article, which is to determine the risk factors for pressure injuries among patients receiving critical care, is fulfilled as the risk factors are identified in the article. The only downside to this article is that it only focuses on patients who are receiving critical care.
The article Prevalence and analysis of medical device-related pressure injuries: results from the International Pressure Ulcer Prevalence Survey is current as it was published in 2018, which is less than five years old and therefore provides current information about pressure injuries. The article covers the information on the prevalence and analysis of pressure injuries from medical devices (Kayser et al., 2018). VanGilder, who is one of the authors, is a clinical research consultant and has sufficient information on the field of medicine. Ayello has specialized in skin and wound care. Therefore, the authors are experts on the topic of discussion. The purpose of the article is to show the prevalence of pressure injuries on ulcer patients and has provided the necessary information to fulfill its purpose.
The publication Back to basics: Preventing perioperative pressure injuries is current in that it is about five years old and provides current information about the prevention of perioperative pressure injuries. The article is also relevant to the topic of discussion, which is pressure injuries. It gives adequate information on prevention as a way of patient safety due to pressure injuries (Spruce, 2017). The author, Spruce, is a professional in the medical field who has specialized in nursing and therefore provides sufficient and credible information about pressure injuries and how they can be prevented effectively through interaction with the patients. The article provides accurate and verifiable facts about pressure injuries and how perioperative nurses should identify and prevent the injuries. The main purpose of the article is to provide the nurse’s ways to prevent pressure injuries for the safety of the patients.
The study Effects of humidity on skin friction against medical textiles as related to prevention of pressure injuries is significant research. The authors – Schwartz, Magen, and Levy, and Gefen – are recognized specialists in the area (Schwartz et al., 2018). This allows stating that the article can be considered reliable and relevant. It also contains Level III evidence, which is a notable point as well. The aim of this article is to define measures that can alleviate and prevent the burden of pressure injuries.
Efficacy of monitoring devices in support of the prevention of pressure injuries includes rationale that is grounded on a systematic review of the related studies from the reliable databases. The immense number of recognized authors demonstrates the considerable credibility of the publication. The article’s aim is to “assess the efficacy of monitoring devices for reducing the risk of developing pressure injuries” (Walia et al., 2016, p. 567). It serves as a solid theoretical background for the topic. The findings are crucial for determining the essentials and severity of pressure injuries.
Solutions
The best way to prevent pressure injuries is to change the position of the body, as a result of which the area of the body is relieved of pressure. If the patient is able to change his position, then this should be done as soon as possible (Spruce, 2017). The position of the body should be changed immediately if the patient feels discomfort in the area of the body under pressure. If possible, the patient in bed should do gymnastics for the limbs. It speeds up blood circulation and helps prevent pressure ulcers. If the patient cannot change his position himself, then for this, one needs to find an assistant. If the risk of pressure ulcers is very high and the patient lies on a regular mattress, then the time spent in one position should be further reduced.
In order to provide good care, it may be necessary to change the entire household in accordance with the needs and capabilities of the patient. Caregivers or family members should have access to the patient’s bed, preferably from both sides. To monitor the condition of the skin, the bed must be in a well-lit area. The more time a patient spends in bed, the more important the quality of the bed and mattress becomes. Ideally, the bed can be height-adjustable to make it easier for the assistant to work and to make it easier to change the patient’s body position. Pressure injury prevention can also be “achieved by ensuring the skin-fabric contact area remains clean and dry; frequent replacement of bed sheets, diapers, and dressings” (Schwartz et al., 2018, p. 873). Therefore, it is advisable to use aids to change the position of the body. The risk of pressure ulcers is higher in malnourished patients. Therefore, special care should be taken in patients with low weight. Nutritional formulas with increased energy value and enriched with minerals and vitamins should be offered.
Conclusion
The above discussion is dedicated to the issue of pressure injuries in the elderly. It was claimed that this problem is currently acute for the mentioned population (Walia et al., 2016). Prevention measures in this regard were claimed to be a crucial foundation for dealing with the problem. The paper utilizes evidence of III, IV, and V levels. It contains a rationale that is grounded on the valid findings of the scholarly dimension. The following key solutions were suggested and can be applied in practice.
First, it is necessary to change the position of the patient constantly. This can avert pressure injures considerably and is the most secure and relevant way (Spruce, 2017). Second, it was claimed that the quality of a bed and fabrics is also important. It deals with the prerequisites of pressure injuries to a great extent (Shwartz et al., 2018). Third, appropriate nutrition is advised, given that the occurrence of pressure injuries is seen among malnourished patients.
This paper’s findings can be used in practice while caring for elderly patients who have the probability of pressure injury occurrence. Moreover, it can be a starting point for conducting some experiments in the topic’s framework. The discussion sheds light on many critical aspects of the issue. Hence, there is a possibility to use it for further full-scale publications. The research design does not imply any ethical considerations or conflicts of interest.
References
Alderden, J., Rondinelli, J., Pepper, G., Cummins, M., & Whitney, J. (2017). Risk factors for pressure injuries among critical care patients: A systematic review. International Journal Of Nursing Studies, 71, 97-114.
Kayser, S., VanGilder, C., Ayello, E., & Lachenbruch, C. (2018). Prevalence and analysis of medical device-related pressure injuries: Results from the International Pressure Ulcer Prevalence Survey. Advances In Skin & Wound Care, 31(6), 276-285.
KU Libraries. (2016). Evaluating sources for credibility. Libraries.
Schwartz, D., Magen, Y. K., Levy, A., & Gefen, A. (2018). Effects of humidity on skin friction against medical textiles as related to prevention of pressure injuries. International Wound Journal, 15(6), 866–874.
Spruce, L. (2017). Back to basics: Preventing perioperative pressure injuries. AORN Journal, 105(1), 92-99.
Walia, G. S., Wong, A. L., Lo, A. Y., Mackert, G. A., Carl, H. M., Pedreira, R. A., Bello, R., Aquino, C. S., Padula, W.V., & Sacks, J. M. (2016). Efficacy of monitoring devices in support of prevention of pressure injuries. Advances in Skin & Wound Care, 29(12), 567–574.