Pressure Ulcers (PUs) or bed ulcer is a significant issue affecting nursing care that causes 60,000 deaths out of 2.5 million patients in hospitalization globally. PUs also contributes to the hiking medical care cost and poor patient outcomes. PU essentially interferes with patients’ quality of life and can be prevented with appropriate nursing care. King Fahad Hospital in Madinah, Saudi Arabia, is one of the largest growing complexes in the Saudi, with a capacity of 500 beds incentivizing appropriate care to reduce incidences of bed ulcers. The National Pressure Ulcer Advisory Panel (NPUAP) gives PU specific recommendations and guidelines that health care workers can leverage in PU management. NPUAP also gives staging procedures to determine the severity of PU. Symptoms of PU are partial skin discoloration, itchiness, swelling and unusual skin texture. King Fahad Hospital has set up policies aimed at curtailing incidences of PU with a key focus on health workers’ training. PU is a hospital-acquired condition affecting long-term hospitalized patients and influences the quality of care whose management largely relies on nursing practice.
A pressure ulcer is a skin and underlying tissue condition associated with extended hospitalization. Critically ill patients and children with less mobility are most likely affected by PU. PU is a predictable condition that can be averted by improving nursing care in health care facilities. The risk factors for PU are advanced age, stillness, incontinence, neurological complications, multiple commodities and poor nutrition. Many patients in the vulnerable categories are confined to hospital beds with the inability to move the body. High-risk patients also have a fragile immune system and skin that can easily be affected. Without proper treatment and care, PU is pernicious, developing deep in the skin and potentially resulting in death.
Being one of the largest medical facilities in the Kingdom of Saudi Arabia, King Fahad Hospital admits patients with the most challenging conditions most vulnerable to PU. The high number of patients admission also makes it challenging to monitor individual patients’ affairs. According to Delmore et al. (2019), lack of education programs to train health workers on UP prevention is the major cause of the challenge. The high patient burden utilizes holistic assessment to determine patients vulnerable to PU in the prevention procedure. Lack of fragmented care potentially increases the risk of contaminating bed ulcers at King Fahad Hospital. In facilities with many admitted patients pose a challenging task of identifying patients at high risk of contaminating PU.
Uncensored patient hygiene, health and nutrition also contribute to PU at King Fahad Hospital. Eating non-balanced food and poor fluid intake magnify the risk of PU. A sufficient supply of nutrients and water is needed to ensure proper blood flow for healthy skin. Poor fluid intake limits blood circulation elemental for skin replenishment. Bad hygiene also makes patients more prone to bedsores and increases the infection severity on contaminated patients. High ill patients who need intensive care, if not adequately cleaned, build up sweat and dirt that poses a great danger to skin health. Substandard patient administration, hygiene and health are the reasons for PU at King Fahad Hospital.
The Key Performance Indicators (KPIs) at King Fahad Hospital are patient outcome, satisfaction, admission and readmission rate. High rates of UP cause patient dissatisfaction, poor patient outcome, and low admission and readmission rates. Quality assurance in health care to guarantee patient safety is a significant factor affecting the KPIs. High cases of UP significantly involve the quality of preventive care provided, and they are often used to measure the quality of nursing care in a hospital (Delmore et al., 2019). Improving patient care to control bed ulcers at King Fahad Hospital will positively impact patient satisfaction, patient outcome, admission, and readmission rates.
The most appropriate model of curtailing PU is through the education and training of nurses. A survey on staff knowledge in PU prevention and management at King Fahad Hospital indicated a deficiency in PU awareness and bad attitudes among health care practitioners (Kaddourah et al., 2016). Categorizing long-stay patients according to their care needs, age, and illness are elemental for intensive UP care. Detailed patient information is essential to identify at-risk persons and implement specific intervention measures. King Fahad hospital should make education and training intervention programs for health care providers to limit PU incidence. The educational programs should be engineered to influence PU risk identification, response and behavior change among healthcare professionals.
The education and training program should pivot on preventive measures and management of PU. Improving patient mobility by turning them and changing their resting position are some of the preventative methods of PU. Nurses at King Fahad hospital should do regular follow-ups of patient repositioning and ensure the head elevation of the patient bed is safe (Kadourah et al., 2016). Oral nutritional supplements such as protein and vitamin to improve diet is also necessary to minimize the risk of PU. Incidences of the ulcers should also be recorded with high precision, such as size, location, and stage of development (Delmore et al., 2019). Nurses can record the progress of PU infection and response to treatment to help prevent the result of the wound to tertiary stages. Maintaining good hygiene standards is a critical PU management practice to minimize the risk of contamination. The overall staff should overlook and contribute to their corresponding duties to improve the quality of care provided. Managing PU is a multi-disciplinary task that requires cooperation between the general staff at King Fahad Hospital.
Patient satisfaction, outcome, admission and readmission rate are the KPIs that should be evaluated continuously to monitor the improvement of healthcare delivery. Since there is no established tool for evaluating patient satisfaction, interviews and questionnaires on discharged patients can monitor patient satisfaction. Patient outcome is integral to surveil the progress in PU cases reported and the severity implicated (Delmore et al., 2019). With continuous improvement in the quality of nursing care, the admission and readmission rates should improve. Collecting data and analyzing data relevant to PU solution will empower King Fahad Hospital to improve healthcare service delivery.
A bed ulcer is a skin condition caused by tissue damage due to pressure limiting blood supply on parts of the skin. Hospitalized and wheelchair-mounted patients are the most vulnerable people to PU. Poor nursing practice and administration are the significant attributes of PU at King Fahad Hospital. High PU prevalence affects patient outcome, satisfaction, admission and readmission rates. Proper training and education of health care practitioners is the ultimate strategy of solving PU at King Fahad. Practices to monitor and enhance patient mobility, hygiene and outcome are critical in PU prevention and management. Individualized assessment of patients during admission also helps identify PU infection risk for better prevention strategies. Data for patient outcome, satisfaction admission and readmission will continuously be collected and evaluated after strategy implementation to measure progress.
References
Kaddourah, B., Abu-Shaheen, A. K., & Al-Tannir, M. (2016). Knowledge and attitudes of health professionals towards pressure ulcers at a rehabilitation hospital: A cross-sectional study. BMC Nursing, 15(1). Web.
Delmore, B., Deppisch, M., Sylvia, C., Luna-Anderson, C., & Nie, A. M. (2019). Pressure injuries in the pediatric population: a national pressure ulcer advisory panel white paper. Advances in Skin & Wound Care, 32(9), 394-408. Web.