DNP 805 Case Report Health Care Informatics

Sample Answer

The treatment and management of diseases in the care environment have undergone drastic changes and evolution in recent years. While nurses have been at the center stage of managing patients with various conditions, the strategies applied in such a process have changed from time to time, with the major focus on coming up with the best strategies.

The implication is that there has been improved patient care, with the patients reportedly experiencing better outcomes. Technology has played a key role in such a process (Nair & Dreyfus, 2018).

Various technological applications have found their way into healthcare and therefore have been used in managing conditions such as pressure ulcers. Therefore, the purpose of this problem is to explore a specific disease process and describe a technological element that can be applied in offering care to a patient experiencing the disease as well as patient practice. In addition, the paper will focus on how the technology will help in integrating treatment within the identified care setting.

The Disease Process and the Problem Statement

Pressure ulcers, sometimes called bedsores refer to the injuries to the skin and other underlying tissues which come from sustained pressure on an individual’s skin. They are commonly experienced on the skin parts which cover the body’s bony areas, such as the tailbone, hips, ankles, and the heals, among others (BoykoTatiana et al., 2018).

Pressure ulcers can be developed by individuals while in various care settings such as rehabilitation, long-term, and acute care facilities. When individuals develop pressure ulcers, they may have an experience of increased pain and prolonged hospitalization, treatment, and healing times. While the problem is prevalent in the acute and long-term care settings, various interventions have been applied in the past with non-satisfactory results.

The implication is that better strategies should be explored to help in managing the conditions better. However, such efforts are dented due to incorrect management of the medical devices and insufficient knowledge regarding pressure ulcer treatment, the risk factors, and the etiology.

The Synthesized Literature Review

The devastating impacts of pressure ulcers in the acute care setting lead to an exploration of literature regarding the existing literature on the conditions. As such, various peer-reviewed article databases were used to obtain relevant articles which have been explored and synthesized in this section.

Gaspar et al. (2019) explored the impact of prevention strategies applied in the prevention of hospital-acquired pressure ulcers. This research entailed a review of close to thirty research articles that reported the prevention strategies for pressure ulcers.

From the analysis, the researcher found out that the use of system reminders on-screen, preventive skin care, educating the health care professional, and application of dressing in the heals, trochanters, and the sacrum was found to be more effective (Gaspar et al., 2019).

In addition, this analysis also found that many of the studies which dealt with the use of multiple intervention programs reported high efficacy in decreasing pressure ulcers. Another highlight of this analysis was that studies which used single interventions such as repositioning and the use of support surfaces were not always impactful in pressure ulcer prevention.

Clay et al. (2018) conducted a study that aimed at determining the incidence and cause of device-associated pressure ulcers and formulate interventions for preventing device-related pressure ulcers. This study focused on exploring two of the most offensive devices, which include the Continuous Positive Pressure and the Bilevel Positive Airway Pressure masks.

Before the use of the proposed intervention, the researchers noted that within a period of two years, the pressure injuries connected to the medical devices were as high as 81% of the hospital-acquired pressure ulcers. The intervention applied in this project was adhesive foam dressing on individuals with the Continuous Positive Pressure and the Bilevel Positive Airway Pressure masks and before orthopedic spinal surgery.

The intervention targeted the prevention of operating room and device positioning pressure ulcers. The application of the intervention led to a drastic drop in the cases of pressure ulcer development.

Mervis and Phillips (2019) also explored strategies for preventing and managing pressure ulcers. According to this research, prevention is the major focus of pressure ulcer research, and even though efforts have been made toward preventing the problem, pressure ulcers are still prevalent in hospitals and community settings.

This source explored various strategies that can be applied to prevent the condition. One of them is repositioning. This strategy seeks to avoid extended periods of locally sustained pressure. Even though there have been suggestions of repositioning after every two hours, several studies have disputed this since studies done by using repositioning every two hours produced non-significant results.

The next intervention explored in this study is the use of support surfaces. This entails using specialized surfaces such as overlays and mattresses that have been made to minimize shear and lower pressure. There are also alternating pressure and constant low-pressure supports that have been used towards reducing pressure ulcers.

These surfaces have been shown to be more effective in comparison to standard mattresses (Mervis & Phillips, 2019). The next intervention that has been applied is nutrition. This intervention has been used as guided by the fact that nutritional deficiencies can lead to skin breakdown. Therefore, as part of the strategy, a nutritional assessment is performed on the patients to help prevent pressure ulcers.

During such assessments, mineral, vitamin, calorie, and protein deficiencies are checked, and necessary steps are taken to ensure that the patient is not deficient in any of them for better pressure ulcer prevention. These researchers also explored the use of dressings such as prophylactic dressings that are key in reducing the impacts of shear and friction.

Dressing such as foams, hydrocolloids, and films are used to minimize the impacts of shear or friction on all the at-risk body parts. Besides, topical agents such as fatty acid creams have also been applied to help in the reduction of pressure ulcer incidences (Mervis & Phillips, 2019). These fatty acid creams include ointments, lotions, and other creams.

The Description of the condition

As earlier pointed out, pressure ulcers are common in care settings and entail injuries to the skin and underlying tissues as caused by sustained pressure on the skin. Even though considerable attention has been given to the condition, it still remains a substantial source of mortality and morbidity (Mervis & Phillips, 2019).

The implication is that pressure ulcers still lead to a considerable burn for the healthcare system and the patients who are impacted negatively in several ways by the condition. Even though pressure ulcers come as a result of overall poor health or due to other medical conditions, most cases of this condition can be avoided or prevented.

As such, various preventive measures have been applied in recent times, which focus on improving the care outcomes at affordable costs. However, in the cases where a patient has already developed pressure ulcers, then surgical management, non-operative strategies, and appropriate wound care are indicated. These treatment and management strategies can be integrated with the preventive measures for better outcomes.

Pressure ulcers can make the patients to have various problems. One of the problems resulting from pressure ulcers is pain. In some cases, pressure ulcers can lead to wounds that can be painful, making the patients experience negative outcomes.

The other impact is longer hospital stays. When patients are admitted to the hospital due to other conditions, the development of pressure ulcers would mean that they may have to spend extra days in the hospital since the condition still has to be managed (BoykoTatiana et al., 2018).

The implication is that these patients can be exposed to other hospital-acquired infections, which can further adversely impact the patient’s condition. Various barriers to care exist. The major barriers include incorrect management of the medical devices, insufficient knowledge regarding pressure ulcer treatment, the risk factors, and the etiology.

The case entails a 50-year-old patient who was admitted to the acute care setting for a bad general condition. The patient was completely immobile and had a history of sclerosis, having experienced multiple cases. The patient had pressure ulcers in the legs and arms.

Even though the patient had been offered some care, it is a great challenge to position the patient since the patient experiences severe pain and also has physical limitations. However, the patient is fully oriented and mentally active.

Description of A technology that can be used as a Solution

Technology and technological applications have been at the forefront of a revolution in healthcare as the treatment and management of various patient conditions these days are becoming more and more technology-based. One of the technologies that be used as a solution to the patient situation presented in the previous sections is alternating pressure mattresses.

The alternating pressure mattresses have air-filled compartments capable of inflating and deflating in a synchronized way to vary pressure across a patient’s body parts continuously (Shi et al., 2021).

Even though the studies regarding the use of alternative pressure surfaces are heterogeneous, specifically on the air cell cycling times and specifications, the use of this technology has been shown to be far more effective in comparison to the standard mattresses used in hospitals.

The Use of Alternating Pressure Mattress

Even though other technological solutions can be applied in the case study discussed in the previous section, alternating pressure mattresses can best fit the patient. The patient feels a lot of pain and also has physical complications and challenges. As such, strategies such as repositioning may be harmful to the patient.

Therefore, alternating pressure mattresses will be helpful as the air-filled surfaces will help in relieving pressure on the area susceptible to the development of pressure ulcers as well as better management of the parts already impacted with the pressure ulcers (Shi et al., 2021).

The use of this technology is key in relieving and redistributing pressure through a dynamic lying surface. While the inflated air cells offer pressure to support the patient, the deflated cells offer relief for the skin above.

The Summary of the Case Integrating Proposed Solution

Pressure ulcers are detrimental to the health of the patients hence a need to control, treat and manage them. As discussed in the literature review section, various strategies have been used in the prevention and treatment of pressure ulcers.

Even though various interventions can be used, not all strategies can be effective for particular cases. For example, the patient explored in this case report experiences a lot of pain and has physical complications, thus making repositioning a non-suitable option.

As such, the use of an alternating pressure mattress has been proposed for this patient (Shi et al., 2021). It is hoped that the alternating pressure mattress will help the patient to recover and prevent further development of pressure ulcers.

Conclusion

Technology and technological applications have been at the center of operations in healthcare and the improvement of healthcare services offered to patients experiencing various conditions. Therefore, this case report has explored the prevention and management of pressure ulcers using alternating pressure mattresses as a technology. In addition, a real-life situation of a patient experiencing pressure ulcers has been explored and discussed.

References

• BoykoTatiana, V., LongakerMichael, T., & YangGeorge, P. (2018). Review of the current management of pressure ulcers. Advances in Wound Care. https //doi.org/10.1089/wound.2016.0697
  
• Clay, P., Cruz, C., Ayotte, K., Jones, J., & Fowler, S. B. (2018). Device-related pressure ulcers pre and post identification and intervention. Journal of Pediatric Nursing, 41, 77-79. https //doi.org/10.1016/j.pedn.2018.01.018
  
• Gaspar, S., Peralta, M., Marques, A., Budri, A., & Gaspar de Matos, M. (2019). Effectiveness on hospital‐acquired pressure ulcer prevention a systematic review. International Wound Journal, 16(5), 1087-1102. https //doi.org/10.1111/iwj.13147.
  
• Mervis, J. S., & Phillips, T. J. (2019). Pressure ulcers Prevention and management. Journal of the American Academy of Dermatology, 81(4), 893-902. https //doi.org/10.1016/j.jaad.2018.12.068.
  
• Nair, A., & Dreyfus, D. (2018). Technology alignment in the presence of regulatory changes The case of meaningful use of information technology in healthcare. International Journal of Medical Informatics, 110, 42-51. https //doi.org/10.1016/j.ijmedinf.2017.11.012
  
• Shi, C., Dumville, J. C., Cullum, N., Rhodes, S., Jammali-Blasi, A., & McInnes, E. (2021). Alternating pressure (active) air surfaces for preventing pressure ulcers. Cochrane Database of Systematic Reviews, (5). https //doi.org/10.1002/14651858.CD013620.pub2