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Pressure ulcer risk factors and appropriate assessment tools: A literature review.

Pressure ulcer risk factors and appropriate assessment tools: A literature review.

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An essay for the 2011 Undergraduate Awards (Lecturer Nomination) Competition by Laura Coyne. It is nominated by Lecturer Brona Mooney of NUI Galway in the category of Nursing & Midwifery
An essay for the 2011 Undergraduate Awards (Lecturer Nomination) Competition by Laura Coyne. It is nominated by Lecturer Brona Mooney of NUI Galway in the category of Nursing & Midwifery

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Published by: Undergraduate Awards on Sep 01, 2012
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10/27/2013

 
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Pressure ulcer risk factors and appropriate assessment tools:A literature review.Abstract
 This focused literature review
*
aims to critically review the literature in relation to the factorsthat predict pressure ulcer development. Another aim of this review involves analysing theliterature to assess which pressure ulcer risk assessment scale is most validated in terms of specificity, sensitivity and inter-rater reliability. The scales which will be discussed includethe Braden, Norton and their modifications as well as the Waterlow Scale.
 
Although 95% of pressure ulcers are preventable they still remain a huge health care burdenin terms of cost and on the quality of care patients receive (Clark, 2002 and Fox, 2002).Therefore, it is vital that nurses are educated on the different predictors for pressure ulcerdevelopment. The literature highlights several different risk factors associated with pressureulcer development. It also illuminates the importance of early recognition of these predictorsin order to implement appropriate preventative interventions.Risk assessment scales are used to aid nurses in accurately identifying patients at risk of pressure ulcer development. The research reports that there is no evidence indicating that theuse of risk assessment scales decreases pressure ulcer incidence. However it has beenidentified that the use of scales in conjunction with clinical judgement increases the intensityand effectiveness of prevention interventions.A critique of the literature focusing on the risk factors for pressure ulcer development and themost validated and reliable risk assessment scale available will assist nurses in informingtheir practice through being able to identify at risk patients using the best tool available. Thiswill allow nurses to put a preventative strategy in place contributing to a high quality of care.
*
Literature Review:
is an organised written presentation of what has been published by scholars. Its purpose is to conveyto the reader what is known in relation to the topic.
 
 
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Table of Contents
Page
Introduction: 1Literature Review Method: 3Literature Review:Section One: Identifying Risk Factors For Pressure Ulcer Development 5Section Two: Using Risk Assessment Scales To Assess For Pressure Ulcer Development 9Discussion and Conclusion: 16Reference List: 19
 
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Introduction
 This focused literature review aims to critically analyse the literature in relation to the factorswhich predispose patients to developing a pressure ulcer in an acute care setting. Another aimof this review involves scrutinising the literature in relation to the most validated risk assessment scale available to assess patients for their risk of pressure ulcer development.
A pressure ulcer has been described as, “localised damage to the skin caused by disruption of 
the blood supply to the area, usually as a result of pressure, shear or friction or a combination
of any of these” (Dealey 2005, p.121).
 Gunningberg
et al.,
(1999) notes that 95% of pressure ulcers are preventable and nursing careis believed to be a primary method of preventing pressure ulcer development. Therefore,accurate identification of at risk patients using a reliable and valid pressure ulcer risk calculator is the first step in preventing pressure ulcer development (Buttery and Phillips,2009, Flanagan, 1993, Davis, 2004, Pang and Wong, 1998). European figures suggest thatapproximately 18% of hospitalised patients have an ulcer at any time (European PressureAdvisory Panel, 2002) (EUPAP). In Ireland, two prevalence studies carried out in the acutecare setting confirmed the extent of the problem and found that prevalence lies between12.5% and 21% (Moore
et al.,
2000).Not only are pressure ulcers damaging to a
 patient‟s quality of life
, they also pose a hugefinancial burden to the health care system. Gethin
et al.,
(2005) estimate the cost of treating
one patient with a grade 4 pressure ulcer successfully at €119,000 and that it costs

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