Paper Sample on National Healthcare Issue

Introduction

Pressure ulcers are a national healthcare problem affecting bedridden patients of all age groups. The condition impacts patients and their families, with more than 40% of patients suffering from severe pain. Besides patients reporting a reduction in their quality of life due to developing pressure ulcers, high mortality rates due to the condition have also been determined (Bereded et al., 2018, p. 847). Other patients experience reduced engagement in social activities, changed body image, and loss of their autonomy. The treatment of pressure ulcers increases healthcare costs, affecting the services' affordability by the majority of patients. An extensive survey conducted in several hospitals in European countries reveals that pressure ulcers in stage 2 and above are more than 10%. The high prevalence occurs in various healthcare settings, including acute care, long term care, and rehabilitation settings.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Order now

The high mortality rates associated with pressure ulcers has made the issue pertinent in my healthcare organization. The treatment and management of patients developing pressure ulcers require substantial financial outlay, which has affected the organization's quality of service delivery. Also, there is increased nursing time spent on monitoring such patients. Thus, most nurses in acute and long-term care have been assigned longer shifts, which has affected their performance. The more extended changes have resulted in burnouts, which have decreased their morale and passion for their role in healthcare.

How the Issue is Being Addressed

Joyce et al. (2018) analyze the various interventions that have been implemented to reduce the incidence of pressure ulcers. Firstly, the study examines the role of care providers in mitigating risk factors associated with pressure ulcers. Changes to professional positions, the establishment of multidisciplinary teams, and interprofessional communication have been identified as some of the provider-initiated interventions that could provide solutions to the issue. Secondly, the study identifies patient-related interventions such as their involvement in healthcare as an effective strategy. Thirdly, structural interventions have also been detailed as critical strategies for reducing pressure ulcers. Structural interventions include changes in the organizational structure, facilities, ownership, and nature of service delivery.

Further, Joyce et al. (2018) highlight that provider-oriented factors such as nursing skills mix, which include the number and the role of specialist nurses, would be vital in implementing solutions. Ensuring interprofessional collaboration and the composition of a wide variety of skills by the healthcare teams would be necessary for addressing pressure ulcers. Because patient-provider interaction has a considerable effect on health outcomes, Joyce et al. (2018) suggest that improving the interaction through effective communication could prove vital.

Various Etiologies

A research study by Bhattacharya & Mishra (2015, p.009) outlines the various etiologies of pressure ulcers. Friction, long duration of pressure on a particular site, and shear are some of the causes of pressure ulcers. Friction weakens the skin by pressure ischemia and makes the skin vulnerable to break down. Patient immobility is another potential cause of pressure ulcers. Immobility of patients increases the pressure threshold on a particular body site, which is a risk factor of possible skin breakdown. Although the pain of pressure ischemia may make patients request to be changed, poor communication from the patient may speed up the development of pressure ulcers. Thus, Bhattacharya & Mishra (2015, p. 009) reiterate that patients with orthopaedic casts should be encouraged to report feelings of discomfort to shield them from developing iatrogenic pressure ulcers.

The hyperaemic cycle's failure has also been noted by Bhattacharya & Mishra (2015, p. 009) as a contributing factor to the development of pressure ulcers. Tissue distortion causes ischemia, which activates blood flow to the affected areas to offer protective mechanisms. When the defensive changes are ineffective, the pain and discomfort experienced activate the central nervous system to relieve the pressure before permanent damage occurs. Once the pressure is reduced, the local capillaries dilate to increase blood flow; a phenomenon referred to as reactive hyperemia. In the failure of such processes, increased pressure on the damaged site causes severe pressure ulcers to develop.

Cleaning the wound is one of the intervention strategies identified by Bhattacharya & Mishra (2015, p. 010) to reduce pressure ulcers. Cleaning of a wound involves removing dead surface tissue and may apply various methods such as mechanical, enzymatic, and biological debridement. Maggots can also be used at the wound site to release bacteriocidal biochemicals and stimulate the wound healing process. Some of the mechanical debridement methods include using laser and ultrasound. When using a laser, the dead tissue is removed by using focused beams of light. Both hydrocolloid and alginate dressing can also be used as part of wound dressing methods to reduce the risk of pressure ulcers.

The use of antibiotics has also been suggested by Bhattacharya & Mishra (2015, p. 014) as a treatment mechanism for pressure ulcers. The use of antibiotics treats the infected pressure ulcer and prevents it from spreading to other body areas. When an infection exists, efforts must be taken to treat the condition, although debridement is necessary only to leave all viable tissues. Bhattacharya & Mishra (2015) suggest that topical antibiotics may be avoided due to increased antibiotic resistance.

Conclusion

Summarily, Joyce et al. (2018) and Bhattacharya & Mishra (2015, p. 015) have outlined various interventions that can be used to reduce the impact of pressure ulcers on healthcare organizations. Specifically, Joyce et al. (2018) address multiple interventions, from provider-initiated to patient-oriented methods to improve bedridden patients' quality of life. The interventions include establishing a multidisciplinary team, combining the nursing skill mix, and availing the necessary facilities. However, Bhattacharya & Mishra (2015) discuss wound cleaning, debridement, and the use of antibiotics as some of the interventions required. Implementing the strategies will positively improve the quality of care within my healthcare organization. Nurses will have more time to spend with one patient, which will also improve their performance. Conversely, implementing organizational changes and provider-initiated interventions will not only consume a lot of time, but it will also lead to substantial financial outlay, which may affect other operational functions of the organization.

References

Bereded, D. T., Salih, M. H., & Abebe, A. E. (2018). Prevalence and risk factors of pressure ulcer in hospitalized adult patients; a single-centre study from Ethiopia. BMC Research Notes, 11(1), 847.
https://doi.org/10.1186/s13104-018-3948-7

Bhattacharya, S., & Mishra, R. K. (2015). Pressure ulcers: Current understanding and newer modalities of treatment. Indian Journal of Plastic Surgery, 48(01), 004–016.
https://doi.org/10.4103/0970-0358.155260

Joyce, P., Moore, Z. E. H., & Christie, J. (2018). The organization of health services for preventing and treating pressure ulcers. Cochrane Database of Systematic Reviews, e1.
https://doi.org/10.1002/14651858.cd012132.pub2.