pressure ulcers in cardiac patients

pressure ulcers in cardiac patients

Introduction

The main goal of the investigation was to assess pressure ulcers in cardiac patients and come up with prevention methods. Upon admission, the selected subjects got placed under two nurses, and the findings recorded throughout. Key data got noted from the nurse’s feedback and compared to data and algorithms that had been prepared before. Data was recorded on 674 pediatric patients who satisfied the required criteria from May 2011 and lasting more than a year to June 2012.

More than 4700 skin assessments got done on the cardiac unit patients in a total of 5918 patient days that represented more than three-quarters of the expected assessments. In every 30 pressure-related injuries, seventy percent was medical-device-related, and the remaining thirty percent was immobility-related. The total number of pressure injuries detected from all the assessed patients was 4.4%, and the device-related ones amounted to 3.1%.

A large chunk of the pressure injuries was at the first stage (forty percent), then the second stage (twenty-six percent), mucosal membrane damage (twenty-six percent), and finally, the anticipated deep tissue damage (seven percent).

The outcome of the assessment supported a program-based approach in the nursing field to better patient outcomes.

Reasons the new nursing practice was put in place

New evidence shows that children, more so than adults, are at a greater risk of sustaining pressure injuries. These injuries are normally a contributing factor to discomfort and pain for the minor patients and their families. Add to that, these injuries mean the minor patients require specialized care, have additional morbidity, and change their body on top of life-threatening complications arising from the injury. There is a sharp increase in these cases in the ICU from a small 0.8 percent to 27%.

Congenital Heart Disease (CHD) is the leading birth defect having almost 40000 victims annually. CHD is the cause of most early childhood deaths. In 2009, there were many methods put in place to fight pressure injuries. However, results were mixed up as there was a spike in other pressure-related injuries. As a result, a special workgroup was put in place to review the prevention efforts put in place.

Additionally, data review in 2010 showed that 46 pressure injuries, with seventy percent being device-related and thirty percent being immobility related. Most of the data from these pediatric studies have been borrowed from the adult studies. Patients with Congenital Heart Disease are excluded from the assessment; hence, no one knows how the pressure injuries relate to CHD.

Has the change been effective?

In the Lindyce Kulik article, the results quoted presented encouraging signs for the future. The SCAMP program is a new innovative way of managing the injuries solely depending on the nursing care of the patients. The above-mentioned case study had the largest number of pediatric patients (674). In the outcome, 29 of the patients assessed were affected by pressure injuries. Seventy percent of the reported cases were device-related, while thirty percent were by immobility. The information collected showed an encouraging reduction of the cases from six percent in 2010 to 4.4%. As a result, nursing practice was altered to include specialized skincare and the need for padding where the medical devices were placed. I can, therefore, agree that the change has been effective in dealing with the issue.

Conclusion

The change in the nursing program has seen positive changes among the patients. Therefore, it is essential the care provided is maintained and improved where possible, to better the outcome of the patients.

References

Lindyce. A. Kulik, Jean A. Connor, Dionne Graham. “Pressure injury prevention for the pediatric cardiac surgical patient using a nurse-driven standardized clinical assessment and management plan.” (2018) Pp. 1-10

Amanda Salick, Allysa Dyson. “Four eyes within Four Hours: A Quality Improvement Project to Decrease Hospital Acquired Pressure Ulcers.”

Yasser Al-Otaibi. “Reducing hospital-acquired pressure injuries.” (2018). Pp. 1-5

Maryann L. Lancaster. “Implementing a Hospital-Acquired Pressure Ulcer Prevention Program.” (2015). Pp. 6-100