The care of patients with pressure ulcers in intensive care units (ICUs) is highly relevant to nursing since the responsibility for this problem often lies with junior medical employees. The need to relate knowledge and existing practices to address the issue is the goal of the Quality Improvement project, and the importance of this activity lies in an opportunity to compile effective intervention algorithms. A patient-centered approach and the use of specific preventive protocols are potentially effective algorithms for patient safety and pressure ulcer management in ICUs.
Clinical Issue Description
The proposed topic for the Quality Improvement project is acute and deserves attention as a relevant gap in modern nursing practice. According to Becker et al. (2017), in ICUs, about 13% of the adult population has confirmed or developing pressure ulcers, and in one-third of them, more than one skin area is affected (p. 56). In ICUs, the problem is exacerbated by such concomitant challenges as stiffness and muscle weakness in target patients. As Deng et al. (2017) note, many risk factors contribute to the development of dangerous skin lesions caused by pressure on certain areas, uncomfortable bedding, and some other causes. Thus, a number of conventions need to be taken into account when managing pressure ulcers in ICUs.
The Rationale for the Need for Changes
In addition to targeting patients’ health concerns, the relevance of addressing pressure ulcers in ICUs lies in the high cost of dealing with the consequences of the problem. Khojastehfar et al. (2020) note that annually, national healthcare systems spend significant funds to address the effects of hospital-acquired pressure ulcers. Nurses and their supervisors are responsible for the safety of the population, and the development of lesions on patients’ skin is a factor that affects the authority of employees and clinics as a whole negatively. In addition, as Khojastehfar et al. (2020) state, in academic literature, much attention is paid to the consequences of inappropriate patient care, but the information may be insufficient about methods to improve the situation for the better and change the status quo. Therefore, addressing the issue in question has value from the perspective of improving the quality of nursing work and helping the target population.
The Best Practices to Introduce
By analyzing the available information on the best practices for addressing the problem under consideration in ICUs, one can highlight effective techniques for preventing and managing pressure ulcers. Dlungwane (2020) provides a list of nursing practices designed to control the condition of the skin of the target audience. In particular, the author draws attention to patient nutrition (protein and carbohydrate components in the diet), special caution with bony areas, and the development of risk-assessment scales as crucial aspects of work (Dlungwane, 2020). Zakaria et al. (2018) focus on a specific nursing protocol that includes a list of preventive and interventional measures designed to identify and address pressure ulcers in ICUs timely. Thus, the targeted work should involve active preventive activities and attention to patients’ individual characteristics.
The development of pressure ulcers in ICU patients is a severe nursing problem, and the analysis of this topic within the framework of the proposed Quality Improvement is essential. The urgency of the problem is high, and the aforementioned statistics confirm the value of work in this direction. The analysis of efficient practices can help identify objectively successful problem-addressing programs and improve the quality of nursing care at ICUs.
Becker, D., Tozo, T. C., Batista, S. S., Mattos, A. L., Silva, M. C. B., Rigon, S., Laynes, R. L., Salomao, E. C., Hubner, K. D. G., Sorbara, S. G. B., & Duarte, P. A. (2017). Pressure ulcers in ICU patients: Incidence and clinical and epidemiological features: A multicenter study in southern Brazil. Intensive and Critical Care Nursing, 42, 55-61. Web.
Deng, X., Yu, T., & Hu, A. (2017). Predicting the risk for hospital-acquired pressure ulcers in critical care patients. Critical Care Nurse, 37(4), e1-e11. Web.
Dlungwane, T. P. (2020). Nurses’ knowledge, attitudes and practices regarding pressure ulcer prevention in the Umgungundlovu District, South Africa. Africa Journal of Nursing and Midwifery, 22(2), 1-17. Web.
Khojastehfar, S., Ghezeljeh, T. N., & Haghani, S. (2020). Factors related to knowledge, attitude, and practice of nurses in intensive care unit in the area of pressure ulcer prevention: A multicenter study. Journal of Tissue Viability, 29(2), 76-81. Web.
Zakaria, A. Y., Taema, K. M., Ismael, M. S., & Elhabashy, S. (2018). Impact of a suggested nursing protocol on the occurrence of medical device-related pressure ulcers in critically ill patients. Central European Journal of Nursing and Midwifery, 9(4), 924-931. Web.