Aga Khan University Hospital, Karachi
Title: A small yet major initiative for the Prevention and Reduction of Pressure Ulcers in ICU setting of Tertiary Care Hospital.
Anam Hakim Tejani is currently working as a Clinical Nurse Instructor at Cardiac Intensive Care Unit, The Aga Khan University Hospital, Karachi, Pakistan
At present, pressure ulcers are one of the leading concerns for health care professionals working at Intensive care units all around the globe, which has a greater impact on morbidity of a patient, thus increases average length of stay. However, its development can be prevented by the utilization of evidence-based nursing practice.
Pressure ulcers development is one of the third costly issues after cancer and cardiovascular diseases (Ghanee, R and Gavami, H, 2010). Florence Nightingale in 1859 wrote, “If he has a bedsore, it’s generally not the fault of the disease, but of the nursing” (Barton, 2009). Nursing practices are vital to prevent pressure ulcer, and its timely evaluation, assessments within 12 hours after admission have been recommended for critically ill patient (He, Tang, Ge & Zheng, 2016).
To reduce hospital acquired pressure ulcers in the intensive care unit using the ‘skin care bundle’. Also, to assess the application of preventive measures at high risk patients for pressure ulcers in Cardiac intensive care unit and the evidence of applied pressure ulcer care bundle in intensive care settings.
It was an experimental study which was conducted in CICU, targeting post-cardiac surgical patients. A tool was developed to assess and prevent the occurrence of pressure ulcers. Moreover, pressure ulcer monitors were delegated for spot checks in all three shifts including morning, evening and night. Additionally, another tool was developed by keeping in view the standardized nursing care for specific stages of pressure ulcers.
The sample consisted of 343 patients admitted in CICU in the first two quarters of year 2018–all the patients underwent through open heart surgery. The study findings showed significant decrease in the occurrence of pressure ulcers and length of stay of post cardiac surgical patients. The pressure ulcers were decreased from 4.7% to 0.5%. Moreover, all applied pressure ulcer preventive measures in this study are in line with the guidelines of the EPUAP.