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There are several real-world nursing challenges in the medical industry. These problems are solved by health professionals hence improving the level of diagnosis and reducing the rate of disease infection among individuals. The study focuses on skin integrity and pressure ulcer as one of the real world nursing challenges
Skin Integrity and Pressure Ulcer
Skin integrity means sufficient skin health and implies that the skin is likely to be damaged, unable to heal or more vulnerable to damages. The pressure ulcer is commonly known as pressure sore, or wound is the injury to the skin and various surrounding tissues. According to Grap et al. (2017), the pressure ulcers form around the body parts and muscles of a human body such as hips, sitting bones, base of a spine, and shoulder bones hence should be given special treatment. Sibbald et al. (2003) argue that if skin integrity is not diagnosed at the earlier stages, wounds become severely infected and are likely to require surgery to repair. Pressure ulcer and skin integrity are significant adverse events that are increasingly causing severe constraint for the patients because they compromise a competent patient’s recovery procedure.
Causes of Skin Integrity and Pressure Ulcer
Major causes of these problems are constant high pressure on the skin as the pressure reduces the blood flow to various areas hence causing damage. For instance, skin integrity and pressure wounds concerns frequently occur if a child remains in the same position for a long duration. Other causes include sliding down abed or a chair and irritation from bodily fluids such as sweat. According to Demarré et al. (2015), immobility, shearing and friction, diminished sensation, excess body heat, poor nutrition, and a decline in mental status are the risk factors for pressure wounds. In their study, Gingrich and Offenback and Pohlman (2018) assert that children and adults at risk of developing the skin integrity and bed sores issues are often paralyzed and do not feel pressure nor pain. Signs and symptoms include pink or red appearance on lighter skin, purple or blue appearance on the dark skin, an occurrence of adverse pain in the affected areas.
The Process of Creative, Real-World Problem Solving
There are several approaches to solve skin integrity and pressure ulcers. However, the team identified weakly or routinely skin assessment as the best device for monitoring the skin firmly. Patients at risk of these problems should exercise a balanced diet, take more water, keep their body clean. In their study Moore and Cowman (2014) outline that patients should apply a barrier cream on the groins and buttocks to prevent their skin from continually absorbing moisture. The team identified that the patients should schedule a frequent visit to orthotists, various seating practitioners and resilient medical equipment retailers to ensure that seating and braces fit correctly.
According to Gingrich, Offenback and Pohlman (2018), people should change positions after every two hours when seated or in bed. For example, dementia individuals should not be kept in one spot for long as they cannot express their needs. Additionally, the team recommends that individuals should frequently use pressure mapping technology through seating specialist and physical therapists to create the map of force distribution in the body. Pressure mapping helps in determining effective ways of reducing pressure in the affected areas. However, if the patient fails to respond to these approaches, wound surgery is recommended.
Creative solutions provided by the Team-The are several innovative solutions for preventing pressure ulcers. The team identified National pressure ulcer prevention (NPUP) with a multidisciplinary team of experts in skin and pressure damage. According to Demarré et al. (2015), the NPUP serves as the critical voice for improved patient outcomes in forced damage and treatment through research, education and public policy. Furthermore, NPUP involves a new staging system characterized by modern technology that offers a faster and reliable diagnosis.
According to Moore and Cowman (2014), National pressure ulcer prevention influences the pressure ulcer strategy in every European nation towards sufficient patient centred and cost-efficient pressure ulcer and skin care. These proposed solutions involve examining the risks factors of the entire population with anticipated better outcomes in patients for a better community hence should be considered authoritative, reasonable and creative. During the study, the team learned several insights about DESIGN, DISCOVER and DELIVERY skills of the original, real-world solving challenge. These include inadequate data about the high prevalence of pressure wounds and skin integrity among the old people and poor assessment skills on patients to determine the occurrence of pressure ulcers. Therefore, the team should engage in more learning and research about skin integrity and pressure wounds to improve these skills for a better and detailed report and presentation. In general, the team exercised an average problem-solving ability
Presenting the solution for the real-world problem-As the nurse in charge of the nursing home, the proposed solution to DON (director of nursing) is to focus and emphasise on the weakly skin assessments, adequate planning and adequate training of patients. Skin assessment provides essential data about the emergence of potential disorders in adults who are more vulnerable to skin injuries. Various staff members (DON, CAN, LPN) from different nursing homes are receptive to the proposed challenge and solution.
In conclusion, one of the critical basic requirements of patients and individuals is to maintain an intact, moisturized and healthy skin continually. An intact skin acts as the body’s primary mechanism of defence against the invasions of various micro-organisms. The surface offers a protective barrier from several environmental threats. Pressure ulcers and skin integrity are best treated through weakly assessment of the surface as required by the national pressure ulcers prevention (NPUP) policy.
Demarré, L., Van Lancker, A., Van Hecke, A., Verhaeghe, S., Grypdonck, M., Lemey, J., ... & Beeckman, D. (2015). The cost of prevention and treatment of pressure ulcers: a systematic review. International journal of nursing studies, 52(11), 1754-1774.
Gingrich, M., Offenback, R., & Pohlman, T. (2018). Preventing Pressure Ulcers and Skin Tears: An Evidence-Based Practice Project.
Grap, M. J., Munro, C. L., Wetzel, P. A., Schubert, C. M., Pepperl, A., Burk, R. S., & Lucas, V. (2017). Tissue interface pressure and skin integrity in critically ill, mechanically ventilated patients. Intensive and Critical Care Nursing, 38, 1-9.
Moore, Z. E., & Cowman, S. (2014). Risk assessment tools for the prevention of pressure ulcers. Cochrane Database of Systematic Reviews, (2).
Sibbald, R. G., Campbell, K., Coutts, P., & Queen, D. (2003). Intact skin--an integrity not to be lost. Ostomy/wound management, 49(6), 27-8.
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