According to Shahin, Dassen and Halfrens (2009) “patients in the Intensive Care Unit (ICU) have a 50% higher chance of developing a pressure ulcer as compared to patients on any other unit in a facility” (para 1). Pressure ulcers are a significant problem in those with complex illnesses or injuries that require admission into the ICU. Upon observation in an ICU many of the patients suffer from pressure ulcers. Registered Nurses (R.N.’s) blame the frequency of pressure ulcers in the ICU on not having enough time and the many machines and monitoring devices that are attached to patients which restricts patient movement.
Pressure ulcer development in patients admitted to the ICU may be classified under the Quality and Safety Education for Nurses (QSEN) topic of safety. By definition, safety reduces the risk of harm to patients and providers thorough system effectiveness and individual performance (Cronenwett et al., 2007). With the prevention of pressure ulcers in this population, patient outcomes significantly improve by eliminating the pain and increased risk of infection associated with pressure ulcers (Cooper, 2011).
Nurse Managers need to educate other nurses about the prevalence of pressure ulcers within their unit. Also, they need to discuss the cost associated with a nosocomial acquired pressure ulcer and pose suggestions on implementing a protocol that reduces the amount of pressure ulcers in ICU patients. By implementing a Pressure Ulcer Care Bundle (PUCB) which uses multiple interventions as described in the study performed by Gray-Siracusa and Schrier, 2011pressure ulcer prevalence can significantly decrease.
Assessment and Analysis
Patients are at their worst when they are admitted into the ICU of a hospital. In order to be admitted to the ICU patients must have complex illnesses or injuries which render them dependent on the staff for their activities of daily living (ADL’s). When nurses fail to meet the basic needs of patient care such as turning and repositioning of the patient pressure ulcers develop. Pressure ulcers are a significant cost to the health care facility since the Centers for Medicare and Medicaid Services will not pay for hospital-acquired pressure ulcers (Cooper, 2011).
Upon observation many patients are not being turned in the ICU due to nurse shortages and complexity of patients illnesses. The result is patients lie in the same position for hour’s and sometimes even days. The current procedure to avoid pressure ulcers in many facilities is turning the patients who are unable to reposition themselves every two hours (Gray-Siracusa & Schrier, 2011). There is nothing wrong with the current procedure as long as it is being performed. Nurses in the ICU may become distracted by the many medications, lab results and monitoring devices that are associated with a patient in the ICU (Gray-Siracusa & Schrier, 2011).
When patients are not turned a minimum of every two hours they are at an...