Prevalence of pressure ulcer in elderly patients



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The Prevalence of Pressure Ulcers in Elderly/ At-Risk Patients In Acute Care Hospitals And Skilled Nursing Facilities

United States University


Uka Anna

January 24, 2021

The Prevalence of Pressure Ulcers in Elderly/ At-Risk Patients In Acute Care Hospitals And Skilled Nursing Facilities


The National Health Service (2020) describes pressure ulcers as “injuries to the skin and underlying tissue, primarily caused by prolonged pressure on the skin.” Also referred to as bedsores or pressure sores, although pressure ulcers can affect any individual, they mostly impact individuals who are bedridden or sit in wheelchairs and chairs for prolonged periods. Pressure ulcers are common on the body’s bony prominences that are put under pressure, for instance, the base of the spine, hips, elbows, and heels (Grey, Harding, & Enoch, 2016). Early symptoms of the condition include discoloration of the skin, itchiness/pain in the affected part, hard/spongy/warm skin in the affected area, and failure of the discolored patch to turn white if pressed (Grey, Harding, & Enoch, 2016). Late symptoms include blisters, open wounds, deep wounds several layers under the skin, and very deep wounds that either reach the bone or muscle (Grey, Harding, & Enoch, 2016).

In this regard, this project aims to explore the prevalence of pressure ulcers on elderly patients and other at-risk patients in acute hospitals and skilled nursing facilities. The project will review the challenges that these healthcare institutions face as they try to ease the pain and discomfort caused by pressure ulcers. It will also assess the viability of the current practices used to deal with pressure ulcers and the reasons behind their failures. Thereafter, the project will present several evidence-based practices (EBPs) that can be adopted by healthcare facilities to better deal with the cases of pressure ulcers in patients. Specifically, the project will discuss the use of three EBPs.

First, there is the Braden Scale. This scale is comprised of six subscales and can be applied in the identification of at-risk individuals in the context of pressure ulcers. It focuses on the individual’s nutritional status, friction and shear, mobility, skin moisture, sensory perception, and activity (Chen et al., 2017). Second, there is the repositioning of the patients. This entails moving a patient to assume a different position with the objective of relieving pressure from certain body areas. Finally, there is the utilization of optifoam dressing on bony areas of the patients. This dressing is renowned for its high-fluid handling capacity and waterproof characteristics (Woo, & Kasaboski, 2017). Thus, it can aid in the faster healing of pressure ulcers.

There are several advantages that can be gained from the implementation of the project. First, the audience will receive comprehensive information regarding the prevalence of pressure ulcers in elderly patients and other at-risk patients in acute hospitals and skilled nursing facilities. Second, the audience will understand the diverse problems associated with pressure ulcers. Finally, the audience will understand the significance of the three evidence-based practices in effectively dealing with the problem of pressure ulcers.

Overview of The Problem

Over the last two decades, there has been a “63 percent increase in pressure ulcers” (Lyder & Ayello, 2018). This is a huge problem because dealing with this condition is quite costly. On average, patients can be charged up to $37, 800 in extreme cases (Russo & Elixhauser, 2016). Also, pressure ulcers result consume a lot of healthcare resources that would have otherwise been redirected elsewhere, considering that these case are preventable. Patients also suffer from this secondary condition, which reduces the quality of their stay in acute hospitals and skilled nursing facilities. According to Lyder and Ayello (2018), pressure ulcers present a huge healthcare problem for millions of adults. They are responsible for hundreds of thousands of hospital stays and a constantly rising number of hospitalizations over the years. Considering that pressure ulcers are secondary health problems that only occur due to patients being bedridden or confined to wheelchairs as a result of other primary health problems, it is vital to find ways of effectively preventing them or managing them effectively. This will have several benefits in reducing healthcare costs and enhancing the quality of life of the affected patients. Acute hospital and skilled nursing facilities are the ones that are mostly affected by this issue.

Considering the nurse shortage in the country, the increase in fragmented care, and the aging population, the problem of pressure ulcers is likely to continue. Therefore, it is important to find a way of reversing the trend so as to eradicate the problems associated with pressure ulcers. This project will significantly contribute to nursing in acute hospitals and skilled nursing facilities because it will present simple but effective ways of dealing with this menace that greatly reduces the effectiveness of the country’s healthcare system. Overall, pressure sores are not the fault of the primary disease in a patient but the subsequent nursing care given to them. Hence, it is crucial to present nurses with EBPs to deal with them effectively.


Chen, H. L., Cao, Y. J., Zhang, W., Wang, J., & Huai, B. S. (2017). Braden scale (ALB) for assessing pressure ulcer risk in hospital patients: A validity and reliability study. Applied Nursing Research33, 169-174.

Grey, J. E., Harding, K. G., & Enoch, S. (2016). Pressure ulcers. BMJ332(7539), 472-475.

Lyder, C. H., & Ayello, E. A. (2018). Pressure ulcers: a patient safety issue. In Patient safety and quality: An evidence-based handbook for nurses. Agency for Healthcare Research and Quality (US).

National Health Service. (2020). Overview – Pressure ulcers (pressure sores). NHS.

Russo, C.A., & Elixhauser, A. (2016). Hospitalizations related to pressure sores. Healthcare Cost and Utilization Project: Agency for Healthcare Research and Quality http://www​.hcup-us.ahrq​.gov/reports/statbriefs/sb3.pdf

Woo, K., & Kasaboski, J. (2017). A Pilot Retrospective Study to Evaluate Two Multi-Layer Foam Dressings for the Management of Moderately Exudative Pressure Injuries. Surgical Technology International31, 61-65.

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