Call Light Pressure Sores and Fall Prevention Essay

Hourly Nurse Rounds, Can They Make a Difference?

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Pressure ulcers or as some refer to as bed/pressure sores or decubitus ulcers are categorized as localized areas of damaged tissue that is caused by shearing forces and excess pressure usually from maintaining the same position over a long period of time. Pressure ulcers typically happen in people who have nerve damage and/or limited mobility. When the person feels pressure, from sitting or lying on any certain body part, this often results in nutrient and oxygen deprivation to the wound or affected area. Strategies to circumvent this involve repositioning. Repositioning consists of moving the person into a different position to give the body the ability to redistribute or remove pressure from the affected area. "Pressure ulcers are distressing events, caused when skin and underlying tissues are placed under pressure sufficient to impair blood supply. They can have a substantial impact on quality of life and have significant resource implications" (Marsden et al., 2015, p. 2879).

Repositioning remains a main prevention strategy. However, it can be labor and resource intensive which often leads to variations in practice. Although repositioning may not help heal a pressure ulcer, it may prevent pressure ulcers from forming. Therefore, research attempts to discover which time intervals are better or worse for pressure ulcer prevention. "People who cannot reposition themselves require assistance. International best practice advocates the use of repositioning as an integral component of a pressure ulcer management strategy" (Moore & Cowman, 2012, p. 1).

The Joint Commission National Patient Safety Goal or JCNPSG states that hospitals and other health care facilities must minimize the risk of patient harm that could result from falls that happen without the supervision of nurses and other hospital staff. Therefore, the organization recommends fall reduction programs and period assessment to gauge effectiveness. Current research provides evidence that hourly nursing rounds along with periodic and continual review of medications can be connected with a decrease in number of falls. Some departments may need this program more than others.

The oncology department and where they do bone marrow transplants, have a patients that experience a higher rate of falling, including facilities that deal with elderly patients. Fall prevention programs have hourly rounds where nurses check for pain, positioning/comfort, personal needs, toileting, and safety checks. Not only are nurses involved, but pharmacists also complete a medication review for these high-risk patients and daily team meetings enable evaluation of the overall process and help to address barriers in real time. In a 2011 study, they observed a hospital that implemented such program and saw that patients experienced higher rate in satisfaction and reduction in falls/injuries.

This reflects a 100% reduction in the fall with injury rate achieved during the study period and contributed to a reduction of 67.8% by the end of fiscal year 2008. Press Ganey scores reflected increased patient satisfaction during this quarter (as compared to the previous quarter) in teamwork=3.7%; attention to special/personal needs=2.1%; overall nursing care=1.9%; and pain control=1.2% (Callahan et al., 2011, p. 1).

These positive results were reflected by aforementioned overwhelming positive feedback from patients. These programs along with repositioning strategies can provide an excellent way to assess patient problems and prevent bigger problems from transpiring over time. Evidence-based practice is the best way to incorporate the latest research into solving real-world problems related to health care.

Questions and Rationale

1. What is the longest wait time between turning intervals that will still remain effective at preventing pressure ulcers?

Although hourly rounds are…