Pressure area care is an inherent plan of care for hospitalized patients. Pressure area sore causes significant pain in adult patients admitted to healthcare settings. This complication is particularly prevalent in bedridden patients and negatively impacts diseases’ prognosis (Mitchell, 2018). The treatment modalities are made difficult due to the frequent infections that accompany the open sores from tissue death secondary to pressure. The combination of pressure and frictions also complicates the necrosis of the soft tissue cells. Therefore, healthcare personnel needs to institute practical actions to ensure the proper implementation of the efforts to promote the pressure areas’ integrity. This paper will evaluate the effectiveness of the implementation of the interventions for optimal pressure area care.
Evaluation of the Interventions Effectiveness
The implementation of the planned strategies for adequate pressure area care was sufficient. Firstly, the two-hourly turning of the immobilized patient was effectively implemented by the staff on duty. The turning charts for the patient were up to date, indicating effective pressure area care. Positional changes in patients unable to move are vital for improving the blood circulation in the pressure areas for adequate tissue perfusion (Mitchell, 2018). Furthermore, turning patients promotes the redistribution of pressure and reduces the sheer mechanical forces necessary for bedsores’ development. Secondly, the nurse practitioners ensured that the patient was dry and continent at all times. Research shows that the skin, which is wet and soiled with urine and feces, is prone to pressure ulcers. Nurses established that the patient received daily bathing with adequate drying of the skin to remove any physical materials that may cause the skin’s tearing. Pressure area care requires the effective implementation of evidence-based strategies for maintaining tissue integrity.
Furthermore, the nurses adequately implemented the techniques to promote the comfort of the patient’s bed surface. The care providers issued a highly specified foam mattress to provide support and comfort required to prevent pressure area sores. Additional pillows were placed under the patient’s pressure areas prone to ulcers, including at the sacral region, below the neck, under the knees, and below the heels (Barakat-Johnson et al., 2018). These materials prevent pressure on the skin of the patient and also promote the equal distribution of pressure. Moreover, the caregivers practiced the ongoing assessment of the patient’s skin for the early signs of damage, including reddened skin, presence of blisters, and swelling of the skin. The nurses also did further documentation of the potential areas of skin damage on the wound chart. The effective assessment of the skin is crucial for prompt management of pressure injuries to prevent complications.
Several mechanisms exist for measuring the effectiveness of the implementations. The goal of the interventions for pressure area care is to prevent the hazards of immobilization, including the appearance of bedsores, avoid the occurrence of infections, and promote the healing of the patient. The absence of injuries on the skin integrity is one of the expected outcomes. Effective implementation of the patient’s two-hourly turnings and applying the pressure-relieving mattress is necessary to promote skin integrity. Another anticipated development of the interventions for promoting optimal skincare is the absence of reddened skin and swellings, which are indicators of excessive pressure on the skin surface. Moreover, the patient is expected to have normal temperature ranges of between 97°F (36.1°C) to 99°F (37.2°C). A high temperature of more than 100.4°F (38°C) is indicative of infections from the pressure area sites (Mitchell, 2018). Hereby attached is a transcript of the interview between a care provider and a patient managed for pressure area care (See Appendix). Therefore, proper implementation of the interventions is vital to preventing the complications of prolonged immobility in elderly patients.
Comparisons of the Effectiveness of the Implementation Plan
The caregivers observed significant differences before and after the actual implementation of the intervention plan. The initial plan projected that the patient would have intact skin and the temperature values within the normal range. The management plan’s further goals were the absence of reddened skin areas, absence of blisters, and improvement of the client’s mobilization. Some of these goals were unmet after the pressure area care plan. The patient had reddened areas on the skin and was still unable to ambulate independently. This observation calls for the institution of additional measures to promote skin integrity and mobilization. Massaging of the skin during bathing of the patient is necessary to promote adequate blood circulation (Yilmazer & Bulut, 2019). The nurse practitioner should also assist the patient in moving. Continuous evaluation of the treatment plan is crucial for monitoring the client’s progress.
Signs of Success
The intervention plan had some commendable success in promoting pressure area care. Firstly, the patient had intact skin, evidenced by the absence of open ulcers on the skin. Secondly, the temperature of the patient during the time of evaluation was 36.8 degrees Celcius. This reading shows the lack of infections due to contamination of the injury sites from the disruption of the skin’s continuity (Yilmazer & Bulut, 2019). There were also significant changes in the patient’s overall condition as he was able to talk to the healthcare providers.
The impaired skin integrity by the pressure area ulcers causes profound pain and disruption on the patient’s quality of life. The nursing interventions to promote pressure areas aims at reducing the pressure on the soft tissue areas. The collaboration of the care providers is necessary for the implementation of pressure area care interventions. Effective implementation is vital for improving the prognosis of the patient. Some signs, including intact skin, normal body temperatures, and absence of reddened skin, indicate the interventions’ success.
Barakat-Johnson, M., Barnett, C., Wand, T., & White, K. (2018). Knowledge and attitudes of nurses toward pressure injury prevention: A cross-sectional multisite study. Journal of Wound, Ostomy, and Continence Nursing: Official Publication of The Wound, Ostomy and Continence Nurses Society, 45(3), 233–237.
Mitchell, A. (2018). Adult pressure area care: Preventing pressure ulcers. British Journal of Nursing, 27(18), 1050-1052.
Yilmazer, T., & Bulut, H. (2019). Evaluating the effects of a pressure injury prevention algorithm. Advances in Skin & Wound Care, 32(6), 278–284.
Transcript of the Interview on the Effectiveness of Pressure Area Care
- Interviewer: Registered nurse TM
- Interviewee: Patient CM
- Venue: intensive care ward
- TM: how are you doing Mrs CM?
- CM: I am doing fine nurse TM
- TM: what can you say about the bed that you are lying on?
- CM: the bed makes me feel comfortable by reducing the pressure on my body parts.