Pressure Ulcer

Pressure Ulcer

Problem Statement

There are approximately 60,000 hospitals in United State in which patients are reported to be dying each year because of hospital acquired pressure ulcers complications. Patients are considered at-risk for pressure injury when interface pressures exceed capillary closing pressure holding upto 32-47 mm Hg which is greater than 2 hours. This may be particularly significant in patients who are going through lengthy procedures related to ancillary on exam table surfaces, it has been observed that the pressures of interface can reach upto 126 - 170 mm Hg. Yet, this important clinical area has been largely ignored by researchers and clinicians. To date, the focus of pressure ulcer risk assessment tools has been almost exclusively on inpatient units, long-term facilities for patient care, and units related to spinal cord rehabilitation. The current risk assessment tools designed for these populations are targeted at features that are injurious and can be risky for the patients for pressure injury from extended disclosure to lower shear and pressures of interface such as incontinence, malnutrition, and immobility. These tools are poorly suited to identify patients at risk for poor tissue tolerance of the shorter-term disclosure to shear and very pressures of high interface encountered during the procedures of ancillary process.

Purpose

The aim of the study is to find tool of assessment for risk related to pressure ulcer that can effectively identify patients at high risk that is cause because of pressure injury during ancillary services procedures so that prevention strategies may be implemented.

Literature Review

Pressure ulcers are primarily manifestations of tissue injury incurred when soft tissues are compacted in between consisting of two firm surfaces (Krouskop, 1983; Schubert, 1994). It happens commonly in the bony prominences of the body where there is a presences of soft tissue that are compacted between an external surface for instance a chair, exam table, or bed, and an unyielding internal bone surface. In a situation when the pressure on the tissues located on the internal sides exceed capillary closing pressure (CCP) of 32-47 mm Hg for longer than two hours, circulation is compromised and tissue anoxia and death can ensue (Defloor, 1999; Maklebust & Sieggreen, 2001). Capillary closing pressure is the pressure required on the capillary bed to completely occlude blood flow in the capillaries.

Although more than 1200 pressure ulcer research studies have been published in the past 15 years, there is not enough evidence present regarding the risk present of pressure injury cause to patients who are undergoing procedures in diagnosis and units of interventional ancillary (e.g., cardiac, renal dialysis, gastrointestinal, radiology, and procedures of vascular labs). Forty-three out of eighty high-risk patients in the study developed some degree of pressure injury during their radiology procedure (Brown, 2002). This is well in excess of the 4% to 38% reported for patients in the general hospital setting (Cuddigan et al., 2001). In the literature there are above 100 risk factors that are reported in literature related to Pressure ulcer (Lyder, 2003). In order to Identify the risk factors ...