Pressure Ulcer

Pressure Ulcer

Introduction

Theories are a set of interrelated concepts that give a systematic view of a phenomenon (an observable fact or event) that is explanatory & predictive in nature. Theories are composed of concepts, definitions, models, propositions & are based on assumptions. They are derived through two principal methods; deductive reasoning and inductive reasoning.

Objectives

* to assess the patient condition by the various methods explained by the nursing theory

* to identify the needs of the patient

* to demonstrate an effective communication and interaction with the patient.

* to select a theory for the application according to the need of the patient

* to apply the theory to solve the identified problems of the patient

* to evaluate the extent to which the process was fruitful.

Nursing theory is an organized and systematic articulation of a set of statements related to questions in the discipline of nursing. A nursing theory is a set of concepts, definitions, relationships, and assumptions or propositions derived from nursing models or from other disciplines and project a purposive, systematic view of phenomena by designing specific inter-relationships among concepts for the purposes of describing, explaining, predicting, and /or prescribing.

Recent Healthcare Initiative On Nursing Practice

Pressure ulcer is defined as localized areas of breakdown of skin and underlying tissues caused by pressure, shear, friction, or a combination of these. They can occur in all situations where subjects are subjected to sustained mechanical loads, but are particularly common in those who are infirm and bedridden, wheelchair bound, or wearing a prosthesis or orthosis. These usually result from local breakdown of skin and soft tissue as a result of compression or shear between a bony prominence and external surface (Lyder CH, 2003). They usually develop on the lower half of the body, two-thirds around the pelvis and a third on the lower limbs, with particularly having predilection for appendages in the lower extremities such as heels and toes (National Pressure Ulcer Advisory Panel, 1989. As is evident, elderly persons are particularly prone to develop these ulcers, especially the age group above 70. Those who had had surgeries for fracture hip or those who had sustained spinal injuries are particularly prone to develop such ulcers.

Interestingly, inadequate and inappropriate nursing care in the inpatient setting has been implicated in the aetiopathogenesis of this disease condition, since statistically the prevalence of pressure ulcers is the maximum among inpatients of the hospital population of this age group. This can be as high as more than 70 in the elderly in-patients with orthopaedic problems (Baumgarten M et al, 2003. The incidence per se is 1 to 5. However, in patients who are confined to bed or to a chair due to their primary diseases, the incidence rises to almost 8. The picture in the long-term healthcare facilities are poorer, since up to 25 of these patients may develop pressure ulcers. There is another significant implication of these data, since pressure ulceration in elderly patients is associated with a five-fold increase in mortality, and in-hospital mortality is in the range of ...