Pressure ulcers (also known as a pressure sores, decubitus ulcers or bedsores) are localized injuries to the skin or underlying tissue, or both. Pressure ulcers usually occur over a bony prominence and are caused by pressure, friction or shear forces(Arora M, 2016). Pressure ulcers are caused by a local breakdown of soft tissue as a result of compression between a bony prominence and an external surface (Grey Joseph et al, 2006). Pressure ulcers remain a major health problem affecting millions of adults in America more especially the aged with multiple commodities. Each year more than 2.5 million people around the United States develop pressure ulcers, and out of this number 60,0000 of those individuals die as a result of those injuries (Kruger et al., 2013). Concerns of pressure ulcers has been a canker from the time the term nursing was coined by Florence Nightingale. In 1859 Florence Nightingale wrote, “If he has a bedsore, it’s generally not the fault of the disease, but of the nursing” (Nightingale F, 1859). This statement clearly defines the degree at which pressure sores has a been a health concern till this modern-day nursing.
Pressure ulcers are amongst the indicators of nursing care quality and nurses play a vital role in prevention and responding to the onset of these ulcers (Khojastehfar et al., 2020). Pressure ulcers have been attributed to diseases that causes their victims to be bedridden. Due to the fact that they are immobile, they remain in a particular spot for an extended period of time putting pressure at bony prominences of their body. Other factors also include patients or people with conditions such as diabetes that causes delay in wound healing for patients that may require long hospital stays for treatment.
Nurses are being trained in school of the number one key method of preventing pressure ulcers and that is by turning patients every two hours. As we get on the field of work, it is been realized that there are other ways employed in the prevention of pressure ulcers that does not involve the traditional method of turning patients. We have realized that there are many new technologies that have been encouraged more in our hospitals and that is the use specialty or mechanical beds. Research has proven that there are considerable variability in techniques used by various nurses in turning patients thereby resulting in a confusing manner in offloading pressure from vulnerable body site(Woodhouse et al., 2019). Nurses have also overall resulted to abandoning the old fashion way of turning patients every two hours to rather rely on the sole operation of specialty bed. Constant or low pressure devices are example devices that made to reduce the magnitude of applied pressure by distributing body weight over a large area(Mcginnis & Stubbs, 2014). For this reason, many nurses including I are left to wonder which way is the most effective method in preventing pressure ulcers. The question many nurses ask is do turning patients every two hours prevent pressure ulcers more effectively than the specialty/mechanical beds. I have therefore developed a PICOT researchable question from this as; Do turning patients every two hours prevent pressure ulcers more effectively than the specialty/mechanical beds?
In my PICOT question, I identified certain key words that influenced my idea on the research topic. I used words such as pressure ulcer prevention, repositioning, positioning, bed sores, specialty bed, early intervention, attitude, knowledge, practice, and many others.
The research database used in this work were the CINAHL Plus with Full Text, Medline with Full Text, Pubmed, Academic Search Complete and Cochrane Database of Systematic Reviews. I have developed certain principles to increase the rigor and effectiveness of database search by reading on recent published article. These new articles contain current trends in evidence practice and I particular ensure I read through the abstracts carefully with critical eye to make my own assessment.
Arora M, C. I. (2016). Cochrane Database of Systematic Reviews Electrical stimulation for treating pressure ulcers (Protocol). https://doi.org/10.1002/14651858.CD012196
Grey Joseph E, Harding Keith G, Enoch S. Pressure ulcers. BMJ. 2006;332:472