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Welcome to Episode 84
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News–
New Studies on Essence of Nursing Workforce in Success of Health Reform
Nursing Voted as Most ‘Ethical and Honest’ Profession
MIHS Develop Protocol to Significantly Reduce Pressure Ulcers
Tip of the Week– Staging Pressure Ulcers For Nurses
Bedsores, more properly known as pressure ulcers or decubitus ulcers, are lesions caused by many factors such as: unrelieved pressure; friction; humidity; shearing forces; temperature; age; continence and medication; to any part of the body, especially portions over bony or cartilaginous areas such as sacrum, elbows, knees, ankles etc.
Stages
Stage I is the most superficial, indicated by non-blanchable redness that does not subside after pressure is relieved. This stage is visually similar to reactive hyperemia seen in skin after prolonged application of pressure.
Stage II is damage to the epidermis extending into, but no deeper than, the dermis. In this stage, the ulcer may be referred to as a blister or abrasion.
Stage III involves the full thickness of the skin and may extend into the subcutaneous tissue layer. This layer has a relatively poor blood supply and can be difficult to heal.
Stage IV is the deepest, extending into the muscle, tendon or even bone.
Unstageable pressure ulcers are covered with dead cells, or eschar and wound exudate, so the depth cannot be determined.
Suspected Deep tissue injury: Purple or maroon localized area of discolored intact skin or blood-filled blister due to damage of underlying soft tissue from pressure and/or shear. The area may be preceded by tissue that is painful, firm, mushy, boggy, warmer or cooler as compared to adjacent tissue.
Interventions
Specific interventions depend on the stage of the pressure ulcer. Management includes wound care, debridement, and infection control.
Preventive measures comprise of turning or changing positions, skin care, early detection through proper risk assessment and more.
See more here
National Pressure Ulcer Advisory Panel
Risk Assessment and Prevention of Pressure Ulcers
CPEGC Prevention of Pressure Ulcers
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Music from The Podsafe Music Network
“Wasting My Time” by Matthew Ebel
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Filed under nursing show podcasts by on Jun 19th, 2009. 3 Comments. 
In research done by the CDC, they reported that MRSA central line-associated bloodstream infections among all ICU types (excluding pediatric units) declined by 50% over the past ten years. Though specific causes of the decline was not observed, they know that certain measures were done including central-line insertion safety and care practices to avoid transmission of MRSA among patients.
The nursing department in one hospital developed a written protocol and a photo book so that every step of the process has a photo and a description below it and was made available in the hospital’s intranet so people can review it at any time.
They also arranged pre-packaged kits for central-line insertion which is more practical and lessens the risk of infection because instead of going to different shelves to get what they need, everything is already encased in a single package. In addition, the chlorhexidine antiseptic skin prep recommended by the CDC was used to replace the older 2% solution since it was more effective.
Nurses were also given the autonomy to stop the procedure while the central line was being inserted when aseptic technique was not followed. This helped diminish central-line associated infections considerably. The nurses played a crucial role in the implementation of the plan since its success depended on their vigilance to accomplish their goal.
This points again to the importance of nurses’ involvement in significant changes in positive patient outcomes and why support of a strong nursing workforce and education system is vital to the overall healthcare in the U.S.
Filed under research for nurses by on Jun 18th, 2009. Comment.
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