For elderly hospitalized patients (P), does the adoption of hourly rounding for nurses (I) as compared to daily baths with chlorhexidine gluconate (O) reduce the rate of incontinence-associated pressure ulcers (O) over a six month program (T)?
The cases of pressure ulcers among the elderly population within the inpatient settings or homecare settings tend to be higher than those in other inpatient or similar settings. This is mainly attributed to the fact that the elderly population has other health issues that affect their functionality and these could range from physical to cognitive issues. On one hand, the physical health tends to affect their vital body systems such as the urinary and digestive system and in many cases leading to incontinence which is typically the loss of control; of the urine or the bowel action. This is further worsened by the associated impact on their ambulatory capabilities such that even in the state of such control of the bowel and balder, they cannot accomplish their toileting needs as would be expected. In the event that these patients are not monitored or managed appropriately, these cases of incontinence become the risk factors for pressure ulcers and with time they may progress to severe wounds that ultimately become the openings for further infection. This in essence diminishes their quality of life, their comfort as well as their self-esteem while elevating the levels of pain and suffering.
The adoption of hourly rounding as a technique to manage and prevent pressure ulcers has been tested over time. This technique involves a policy that requires the on-shift nurse to make regular one-hour intervals to each patient so as to help them accomplish their needs as they may arise. This technique ensures that the patient needs are met at the time they present including appropriate toileting, medication and dietary needs. On the other hand, the use of chlorhexidine gluconate for daily baths for these patients is another technique that can be adopted. This purpose here is to ensure that even as incontinence may happen there are very low chances of pressure ulcers or infections occurring.
References
Bergstrom, N., Horn, S. D., Rapp, M., Stern, A., Barrett, R., Watkiss, M., & Krahn, M. (2014). Preventing pressure ulcers: a multisite randomized controlled trial in nursing homes. Ontario health technology assessment series, 14(11), 1.
Viray, M. A., Morley, J. C., Coopersmith, C. M., Kollef, M. H., Fraser, V. J., & Warren, D. K. (2014). Daily bathing with chlorhexidine-based soap and the prevention of Staphylococcus aureus transmission and infection. Infection Control & Hospital Epidemiology, 35(03), 243-250.
