PICOT question is an approach used to identify the components of any clinical issue. Pressure Ulcer that is also commonly referred to as bedsore is an injury of the skin or tissues caused by moisture, friction, and pressure. The disease arises when a patient does not have space for mobility or cannot change its position on his own by lying on the bed.
PICOT question for Pressure ulcers in the hospital is as follows:
Does turning and repositioning of critically ill patients after regular intervals help to prevent pressure ulcers as compared to pressure redistributing support surfaces?P: Critically ill patientsI: Repositioning and Turning patient at regular intervalsC: Pressure redistributing support surfacesO: Prevention of pressure ulcers
T: Time frame from 2006-2015
The purpose this study is to investigate and compare which intervention method is suitable for preventing pressure ulcer in patients who are critically ill.
Critically ill patients
The survey provides statistics that indicate that there has been more than 80 percent increase in the number of patients who are in a critical condition during 1993-2006 (Chaiken, 2012). The early interventions for this at-risk population are not systematically implemented or documented. The life of the patient is at risk due to the harmful disease that results in skin breakdown. The reason for the increase in number of patients is the lack of communication between nurses in hospitals.
Repositioning and Turning
Repositioning and turning allow nurses to check redness and sores suffered by patients after few hours. (Cooper, 2013). It also helps in keeping the blood flowing if repositioning is exercised after one or two hours. The average blood pressure range set by the doctors is 20 to 40 mm Hg, and it needs to be assessed every one or two hours to avoid the risk of disease. Repositioning and rotating also allows the skin to remain healthy and save patients from bedsores. When capillaries supply blood to the skin and the tissues are pressed amounts to the low external pressure that is 32 mm Hg that is sufficient to protect patients from pressure ulcers. It should be noticed that lowering of the external pressure could be due to the instability of hemodynamic and comorbid conditions.
Pressure redistributing support surfaces
Pressure-redistributing support surfaces (PRSSs) is an effective innovation to prevent pressure ulcers in the patients. It is a preferable option for preventing the spread of disease in the hospitals. Although there is no strong proof for determining the reliability of PRSS, clinical practioners use this to ensure high prevention techniques to control the disease. Other preventions include nutritional supplementation, wheelchair cushions, and heel boots.
The techniques are also useful to prevent adults from this harmful illness. The effectiveness can be ensured by using continuous bedside pressure mattresses as a reliable tool to avoid it.
Prevention of pressure ulcers
The repositioning and PRSS combined can help in preventing the pressure ulcers in patients. Alternating Air Mattresses, Overlays, and Bed Systems are also effective in preventing pressure ulcers in hospitals. The implementation of the program that provides a solution to the measures of risk factors in preventing is also helpful in reducing the disease too. (Chou, et al., 2013). The study reveals that it is a challenging situation to promote the culture of preventing pressure ulcer within clinics and hospitals. It also requires the support of administration and leaders of the healthcare institutions.
PRSS are helpful in improving the statistical figures of pressure ulcer patients, but there is a need for more evidence that supports PRSS in the postoperative setting. Pressure-redistributing support surfaces and turning and repositioning, when combined, are more effective in the prevention of pressure ulcers.
References
Chaiken, N. (2012). Reduction of sacral pressure ulcers in the intensive care unit using a silicone border foam dressing. Journal of Wound Ostomy & Continence Nursing, 39 (2), 143-145.
Chou, R., Dana, T., Bougatsos, C., Blazina, I., Starmer, A. J., Reitel, K., et al. (2013). Pressure ulcer risk assessment and prevention: a systematic comparative effectiveness review. Annals of internal medicine, 159 (1), 28-38.
Cooper, K. L. (2013). Evidence-based prevention of pressure ulcers in the intensive care unit. Critical care nurse, 33 (6), 57-66.
