Essay - Role of Staff Education in Pressure Ulcer Incidence in Long-term...

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Statement of the Problem

Pressure ulcers (PUs), also known as bed sores, decubitus ulcers, or pressure s*****es, are formed where skin and tissue are squeezed between bone and an outside surface for long periods of time, *****ten due to immobility ("Pressure Ulcer," 2002). The development of PUs is a common problem in long term c*****re of ***** elderly. A recent report by a n*****tional pressure ulcer organization estimates the prevalence of ***** in acute care at about 15%, with about a 7% incidence *****fter admission (National Pressure Ulcer *****dvisory Panel, 2001).

Because PUs are so common, cause distress ***** the patient and their family, and can form the basis for litigation, it is important for the long-term medical care community to find ways ***** reduce ***** prevalence ***** *****. Two commonly suggested solutions to the PU ***** include identifying patients at r*****k using risk as*****sment methods and initiating preventive measures (Ayello & Braden, *****). In order ***** long term care staff to identify patients at risk ********** must be educ*****ed in assessment of the risk for develop*****g PUs. One ***** assessment method used in this area is the Braden Scale, developed in 1987 by Drs. Barbara Braden and Nancy Bergstrom. The scale attempts to identify risk factors that increase the chance that patients will develop PUs in the future and assigns a numeric value to the risk for any particular patient (Bergstrom, *****, Laguzza, & Holman, *****).

Rationale for the Study

This study will attempt to evaluate the effect ***** tra*****ing staff in a long-term care facility ***** the use of the Braden Scale on ulcer incidence. It will do ***** by examining three ***** before and after training in the use ***** ***** Braden Scale: (1) the overall incidence of ulcers, (2) the average ulcer development time, and (3) the average ulcer healing time.

Definiti***** of Terms

***** Scale -- a ***** ***** method for ***** development of ***** ********** that examines various factors and assigns a numeric value ***** the potential risk.

***** Data -- data concerning events occurring before a subject is enrolled in a study.

Prospective Data -- data concern*****g events ***** after a subject is enrolled in a study.

Quasi-Experimental -- a ***** of qu*****ntitative research design that examines causality; it does not include random selection ***** *****s or control groups.


***** presentation of the theoretical and research ***** for the study

***** Braden Scale is a risk assessment method ***** the development of pressure ulcers ***** was formulated in *****987 (Bergstrom et al.). Since that time, a large number ***** studies have been done to try ***** determine if the scale is reliable (consistent) and valid (accurate) in predicting those patients that will develop pressure *****. Work by Braden herself indicates that the scale ***** have clinical utility, predictive utility, and extends to various healthcare settings (***** & Bergstrom, 1989; Bergstrom, Braden, Kemp, Champagne, &


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