Nursing Research Questions Assignment

What is the problem?

This paper will focus on outlining and describing the risk factors of elderly patients with chronic conditions in long-term care facilities, for developing PUs and on identifying the current tools for assessing RNS knowledge and skill in PU prevention and management. PUs are serious complications that restrict the mobility of patients, such that patients with chronic conditions are limited to beds or chairs (Werdin et al., 2009). In 2007, the Wound, Ostomy and Continence Nurses Society (WOCN) defined PUs as localised injuries in the skin or tissues, which are caused by long run pressure or friction on the specific area being affected by Pus (Bhattacharya & Mishra, 2015). The number of conflicting factors contribute to development of PUs, including; physical and pathological factors. Unrelieved pressure, shearing forces, friction and moisture are considered as common physical factors which contribute in development of PU. Additionally, the pathological factors include; impaired blood supply in capillaries and high pressure on cell membranes of muscles (Al-Dorzi, 2017). Age and immobility also play role along with physical and pathological factors in development of PU and thus it can be concluded that there are numerous risk factors which might lead to PU development. The details of pathophysiological factors which contribute in development of PU, can be seen in figure 1. 

Figure 1. Pathophysiology of pressure ulcers

Why is this a problem?

PUs remain common problems in all healthcare settings, especially among elderly bedridden patients in long term-care facilities. PUs are recognised as a major cause of increased morbidity and mortality that can potentially be prevented (Dumville et al., 2015). Patients admitted to long‐term care units are found to have an increased risk of developing PUs. Additional complications associated with PUs include emotional factors. The most common problem PUs cause is emotional distress in both patients and their families that leads to dissatisfaction with the healthcare system. Further, the resulting limited patient mobility may prolong the healing period and can put patients at additional risk. As noted by Moore & Cowman (2015) the immobility can worsen the situation and thus disease can become acute for elderly patients who are bedridden, and can take even longer to heal. In addition to these complications, PU can lead to serious complications among patients. For instance, as mentioned by Reddy, Gill & Rochon (2006) PU can lead to; cellulitis which is acute infection of skin tissues, bone and joint infections and cancer. These evidences clearly show that PU is highly important issue which needs consideration by researchers and practitioners.                  

• What do you want to do about it?

It is evident that most patients in long-term care facilities have diseases which can eventually contribute in development of PUs. For instance, previous strokes, neurological diseases and diabetes, which could increase the risk of patients developing PUs. Additionally, some extrinsic risk factors in long term care facilities also contribute in formation of PU, such as poor nutrition, limited mobility, poor mattress condition and hygiene neglect (Livesley & Chow, 2002). All of these evidences clearly indicate that there is some issue with care of elderly patients in long term care facilities, which lead to development of PUs and thus study is aimed to highlight the issues that are causing PUs among elderly patients. For instance, aside from patient health conditions, care quality and insufficient numbers of healthcare providers and nursing staff in long-term care facilities may be associated with PU development. As noted by Reddy, Gill & Rochon (2006) infrequency of patient assessment in long-term care facilities and occurrences of untrained nurses conducting assessments could cause symptoms to go unnoticed even with screening tools (such as the Norton and Braden Scales). This negligence, not only affects patients’ condition but also affect the length of hospital stays and increase care cost (Werdin et al., 2009). Therefore, the following study is focusing on the risk factors of PUs development, along with tools used to assess knowledge of RNs about PU. The results of study will help the long term care facilities to improve skills and knowledge of their RNs with regard to care of patients with PU. Additionally, the findings will enable them to control all risk factors which cause PU among elderly patients in long term care facilities.  

How does this area of nursing practice build on your current practice? 

The current practice of researcher is of Long Term Care, which is closely linked with care of patients with regard to PU treatment. In order to assure effective care of patients with PU, there is need to clearly understand the different stages of PU. Additionally, in order to support wound healing among patients of PU, it is important to understand about the stages of wound and strategies to improve the wound healing process.