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Transcript of Decubitus Ulcers
-Fecal and urinary incontinence
-Decreased mental status
-Excessive body heat
-Chronic Medical Condition
The most important cause is externally applied pressure for an excessive period of time. Further damaging factors include friction at the skin surface, shearing forces, and moisture.
1. Skin in tact, red and nonblanching
2. Partial thickness skin loss
3. Full thickness skin loss
4. Tissue death, damage to muscle, bone or supporting tissue
-are easily diagnosed by looking at them
-PREVENTION is key!!!
-Braden Scale is used to determine risk
-Irrigate with saline
-Maintain clean moist wound
-Negative pressure wound therapy
-Assess for pressure ulcer risk and reevaluate frequently using Braden Scale
-Rotate patient every 2 hours
-Assess and treat pain
-Measure size of the ulcer
-Monitor for infection, check WBC, culture wound
-Collaborate with Dietician, Surgeon, PT, Social Worker
Medicare and Medicaid do NOT reimburse for Pressure Ulcers
because they are 100% PREVENTABLE
Bone and Joint infections
Disturbed Body image
-Social worker to help find resources
-Education about prevention
-Instruct them to check skin daily
-Keep skin clean and dry
-Avoid cold dry air
-Cornstarch can be used to reduce damage from friction
-Pad bony prominences
60% of pressure ulcer cases occur in elderly
Strasser, L. (2012, November). Improving Skin Integrity in the Perioperative Environment Using an Evidence Based Protocol. Journal of the Dermonatological Nurses Association, 4(6), 351-360.
North Carolina Concept-Based Learning Editorial Board. (2011). Nursing; A Concept Based Approach to Learning. New Jersey: Pearson.
Gulanick,M. & Myers, L. J. (2011).Nursing Care Plans : Diagnoses, Interventions, and outcomes. St. Louis , Missouri; Elsevier Mosby.
Pressure ulcers can occur on ears, on the skull, shoulders, inner knees and inner ankles.
Why don't healthy people get pressure ulcers why they sleep? Studies found that we rotate on average 20 times during the night!
The cost per patient: some estimates range between $37,800 and $70,000, with total annual costs in the United States as high as $11 billion
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